Everything you need to know
For couples who have been waiting a long time to get pregnant despite having unprotected sex, should definitely consider a spermiogram. This examination can determine whether the cause of the unfulfilled child wish lies with the man. Despite the widespread assumption that infertility is “primarily a woman’s issue”, the cause of unwanted childlessness is more or less equally divided in both men and women.
The spermiogram — fertility test for men
We reveal how a spermiogram works, what the results can be and what men can do to improve their sperm quality.
What is a spermiogram?
A spermiogram is the fertility test for men. Through a detailed examination of the male ejaculate in the laboratory, the sperm quality and the man’s ability to conceive can be checked.
Except in cases of unwanted childlessness, a spermiogram is also carried out after a vasectomy (sterilisation of the man). This can be used to determine whether there are really no more sperm in the ejaculate and whether the procedure was therefore successful.
The procedure for a spermiogram is painless and without any side effects. The only thing the man has to do is give his sperm to the laboratory. The subsequent analysis will determine whether :
- there are too few sperm in the ejaculate (oligozoospermia)
- the sperm are too immobile (asthenozoospermia)
- there is a malformation of the sperm (teratozoospermia).
In addition, the following criteria of the ejaculate are evaluated:
- Characteristics such as odour and colour
- Sperm antibodies (MAR test)
- Bacterial colonisation
- Sugar content
The costs of a spermiogram are usually between 60 and 90 euros . For couples who have not been able to conceive a child despite unprotected sexual intercourse over a longer period of time, the costs of the spermiogram are covered by the health insurance. If you want to be on the safe side however, it is advisable to obtain written confirmation from the health insurance fund before the procedure.
More information on financial support for wanting a child.
In order to get a meaningful test result, it is recommended that you abstain from sex and masturbation for about four to five days before the procedure. However, abstinence should not last longer than seven days, because even though this increases the number of sperm in the ejaculate, their motility deteriorates after this period.
On the day of the spermiogram, a semen sample must be given by means of masturbation. It is important to strictly follow all the doctor’s instructions, to wash the hands and penis thoroughly before masturbation and to use a sterile container for ejaculation. At the time of delivery, the sample must be very fresh and no more than half an hour old .
As soon as the semen sample has been delivered to the laboratory, the actual examination begins. First, the liquefaction and volume of the ejaculate are tested . If they do not correspond to the norm, these can be the first signs that the man is unable to conceive.
Then the analysis begins under the microscope, during which the number, mobility, shape and other parameters are tested. The determination of the result can take between one and seven days, depending on the laboratory.
But don’t panic if the result is negative the first time: since the quality of the sperm varies weekly and even reveals the man’s state of health on the day of the examination, the test can be repeated with fresh sperm around eight to twelve weeks later .
The evaluation of the spermiogram shows whether the patient is fully, partially or not at all fertile. The result thus provides some clarity for the couple’s situation. For the professional performance of a competent semen analysis, the World Health Organisation (WHO) published guidelines on the “Evaluation of Fertilisable Sperm” in 2010 . In this way, a globally valid standard can be ensured. The following table lists the general standard values of a spermiogram that are used for evaluation :
Normal values of a spermiogram:
Volume in ml: at least 1.5ml
Total number of sperm: at least 39 million
Proportion of living sperm: at least 58
Sperm per ml: at least 15 million
pH value: between 7 and 8
Proportion of well-motile sperm: at least 32%.
Proportion with normal shape: at least 4%
White blood cell count: less than 1 million per ml
Liquefaction time: between 30 and 60 minutes
MAR test: below 50% sperm antibodies
If the spermiogram results are negative even after repeated attempts, further tests are in order. Among other things, an ultrasound examination of the man’s testicles and prostate, as well as a blood or hormone test could be useful. There are many diagnoses that are found as a result of a spermiogram evaluation. These include:
- Oligo-Astheno-Teratozoospermia Syndrome (OAT syndrome) — A pathological change in semen quality. This occurs when there are too few, too immobile and malformed sperm in the ejaculate at the same time.
- Azoospermia — No sperm at all can be found in the ejaculate.
- Aspermia — This occurs when no ejaculate could be obtained.
- Parvesemia — The volume of the ejaculate is below the WHO standard (min. 1.5 ml).
What can you do to improve sperm quality?
And now for the good news: Unlike women, who are born with a limited number of eggs, men are always forming new sperm. So the spermiogram is more or less a snapshot. And this can be positively influenced!
As is so often the case, a change in lifestyle can be a great help. This includes a healthy and balanced diet and sufficient vitamin intake (zinc, vitamin C, selenium). In addition, sport and exercise are very important because they increase testosterone levels, which are essential for sperm production. In contrast, men who are overweight have been found to be deficient in testosterone, which can cause sperm quality to suffer significantly .
It is also advised to abstain from or at least reduce the consumption of the usual culprits such as alcohol, nicotine and anabolic steroids .
Heated seats in the car, too tight pants and other factors that can lead to overheating of the semen should be avoided as far as possible. It is not for nothing that the testicles are located outside the body, as the body temperature would be too warm for them. So nature has once again thought of everything!
Other factors are stress, and the “pressure to procreate” that often accompanies couples with an unfulfilled child wish. Even if it is not always easy, one should try to minimize stress and unproductive worries. They help no one and can only lead to further problems.
To learn more about the connection between fertility and psychological factors, click here!
No one can guarantee that these measures will work in every single case, but they are definitely worth a try. And even if they don’t always help you to fulfill your desire to have children, you are doing your health and yourself a favor in any case.
The At-home sperm test
Take your fertility into your own hands!
Improving your sperm health increases your chances of conception. With the At-Home Sperm Test, you can easily check your sperm quality from the comfort of your own home. Using advanced fertility technology, you’ll receive accurate information about the volume, concentration and mobility of your sperm on your smartphone in only 15 minutes. The app also provides you with valuable personalised tips to improve your sperm health.
Social freezing: success rates
What is the ideal age to freeze my eggs? This is an often asked question in the context of social freezing. A simplified answer would be that it is generally better to freeze at a younger age than at a later age. However, it is not quite that simple.
At Fertilly, we have made it our mission to accompany couples (homosexual and heterosexual) and singles on the way to fulfilling their child wish. In doing so, it is important to us to create transparency in the area of fertility services, to provide information and knowledge on the topics of pregnancy and fertility and to help you to find the most suitable Fertility Center. Through cooperation with first-class Fertility Centres and clinics in Europe, enquiries about Fertilly are given preferential treatment. This means that our patients avoid the usually long waiting times and get appointments more quickly.
If you would like more information about Fertility Centers, success rates and prices, please contact us using this questionnaire. We will advise you free of charge and without any obligation.
Answer the first questions in the online form in order to book an appointment. This way we can better address your needs during the conversation.
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1. DocCheck Flexikon, 2017. Spermiogramm — https://flexikon.doccheck.com/de/Spermiogramm#Untersuchte_Merkmale
2. Hermes, S., o.D. Spermiogramm: Wie fit sind deine Samenzellen? ‑https://www.eltern.de/kinderwunsch/fruchtbarkeit/spermiogramm-kosten-auswertung%20#section_46627 (Zugriff am 10.07.2019)
3. Breitbach, E., 2019 — https://www.wunschkinder.net/theorie/diagnostik-der-sterilitaet/diagnostik-beim-mann/#untersuchung-des-ejakulats-spermiogramm
4. Manski, D., 2019. Spermiogramm (Ejakulatanalyse): Durchführung und Auswertung. — https://www.urologielehrbuch.de/spermiogramm.html
5. Bundeszentrale für gesundheitliche Aufklärung, 2017. Der Samentest: Bin ich fruchtbar? ‑https://www.familienplanung.de/kinderwunsch/diagnostik/untersuchungen-mann/der-samentest/
6. Wu, F., et al. (2008, Jul). Hypothalamic-pituitary-testicular axis disruptions in older men are differentially linked to age and modifiable risk factors: the European Male Aging Study. J Clin Endocrinol Metab , 93 (7), pp. 2737–45.
7. Wintermantel, B., o.D. — https://www.eltern.de/kinderwunsch/fruchtbarkeit/kinderwunsch-was-kann-er-tun.html