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The basic semen analysis comprises the following:
Macroscopic assessment
The first assessment includes to note visual appearance (color, viscosity), any smell, and determination of semen volume.
Basic observations in the microscope
The first microscope assessment includes a survey of presence of sperm, if they are motile, and if there are other cells, larger particles, or aggregates of sperm. With this survey as a ground, the proper dilution for sperm concentration can be chosen.
Assessment of sperm motility
Sperm motility is determined in several microscope fields. Sperm har counted in four categories: rapidly progressive, slowly progressive, non progressive, and immotile.
Determination of proportion live sperm
If no, or very few, sperm are motile you need to determine if the immotile sperm are dead or alive. Usually a stain that is only taken up by dead sperm is used. Unstainde, live sperm can be found in men with a genetically caused sperm tail immobility.
Assessment of sperm morphology
An important task is to assess the appearance of the sperm - morphology. The recommended procedure is based on studies of the morphology of sperm which have made their way close to the site of fertilization and bound to the outer vestments of the oocyte. The morphology of sperm can only be assessed in detail in properly stained smears.
Determination of sperm concentration and total sperm number
The number of sperm in a sample is determined by diluting an exact volume of semen and thereby concomitantly inhibiting the motility when the cells are counted in a special counting chamber. Duplicate counts are done and the results are only accepted if the two counts agree. The total number is calculated from the concentration measured in the counting chamber and the sample volume determined at the beginning of the investigation.
Other investigations
Besides these basic investigations the laboratory can determine the concentration of white blood cells, presence of antisperm antibodies, markers for secretion from the prostate, seminal vesicles and epididymis, and investigate how many sperm that can be obtained when sperm are prepared in the same way as for treatment (Assisted Reproductive Techniques, ART).
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