Male Factor Evaluation
Detailed History regarding work, Habits is taken. Physical examination of male is done to assessed testicular volume and check any abnormality. Semen analysis / Semno gram is ordered. If necessary scrotaldoppler, TRUS are done. At least two semen analysis reports are necessary for diagnosis.
Semen analysis comprises a set of descriptive measurements of spermatozoa and seminal fluid parameters that help to estimate semen quality
Conventional semen analysis includes measurement of particular aspects of spermatozoa such as concentration, motility and morphology and of seminal plasma. Quantification and identification of non-spermatozoidal cells and detection of antisperm antibodies are also part of basic semen analysis.
Normal values of semen parameters issued by the World Health Organization (WHO) in 1992 are generally used as reference values (Table I).
Ideally, each laboratory should set its own normal values, reflecting the specific population analyzed.
Table I. Normal values of semen variables (WHO 1992)
| Standard tests | |
| Volume | 2.0 ml or more |
| pH | 7.2-8.0 |
| Sperm concentration | 20×106 spermatozoa/ml or more |
| Total sperm count | 40×106spermatozoa per ejaculate or more |
| motility |
50% or more with forward progression(categories a and b)or 25% or more with rapid progression(category a)within 60 minutes of ejaculation |
| morphology | 30% or more with normal forms |
| Vitality | 75% or more live,i.e.,excluding dye |
| white blood cells | fewer than 1×106/ml |
| Immunobead test | fewer than 20% spermatozoa with adherent particles |
| MAR test | fewer than 10% spermatozoa with adherent particles |
| Optional tests | |
| a -Glucosidase(neutral) | 20 mU or more per ejaculate |
| zinc(total) | 2.4 m -mol or more per ejaculate |
| citric acid(total) | 52 m -mol or more per ejaculate |
| acid phosphatase(total) | 200 U or more per ejaculate |
| fructose(total) | 13 m -mol or more per ejaculate |
| Table II. Nomenclature for semen variables (WHO 1992) | |
| normozoospermia | normal ejaculate as defined in table I |
| oligozoospermia | sperm concentration fewer than 20×106/ml |
| asthenozoospermia | fewer than 50% spermatozoa with forward progression(categories a and b)or fewer than 25% spermatozoa with category a movement |
| teratozoospermia | fewer than 30% spermatozoa with normal morphology |
| oligoasthenoteratozoospermia | signifies disturbance of all three variables(combination of only two prefixes can be used) |
| azoospermia | no spermatozoa in the ejaculate |
| aspermia | no ejaculate |
