For many men, after undergoing tests, the following question arises: what to do if a bad spermogram? This is especially true in cases where a young couple wants to have a child.
Surely many have heard the term "male factor". This means that the reason for the absence of children in the family is directly related to the man's infertility. In the first months of attempts at conception, it is too early to talk about such an indicator, but if more than a year has passed and the girl has not become pregnant, you should consult a doctor and find out the exact reason. According to statistics, about 15% of young couples face difficulties in conception. And in 1/3 of cases the reason is the man and his health problems. And in ¼ of all cases of infertility, the reason lies in women's health.
Analysis for conceiving a child
A spermogram is an analysis of a man's sperm, which is carried out specifically to determine his ability to conceive a child. This is an indicator of health, thanks to the results of a spermogram, it is possible to diagnose many diseases associated with the reproductive system and determine the main cause of infertility.
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In the case when the result of this analysis is normal, it is enough to take it only once. But in cases where the spermogram is bad, then it is necessary to be examined several times. In this case, it is necessary to make an interval between the delivery of the analysis from 1 to 3 months. Between receiving the results, the doctor will prescribe a course of treatment, the results of which will be visible when the next spermogram is taken. In the laboratory, studies are carried out that determine the basic physical and chemical parameters of semen.
Preparatory activities
If you decide to do a spermogram, then you need to know a few basic rules, how to prepare and what is the process of passing the analysis. So, first of all, a man needs to refrain from sexual intercourse for 3 days before visiting a doctor. The thing is that for a reliable result, the presence of at least 2 ml of ejaculate in the semen is necessary. And with regular and frequent sexual intercourse, each time the concentration of spermatozoa decreases, which will affect the correctness of the results. Therefore, if you want to find out the cause of infertility, you need to abstain for several days and get a complete picture of your male health.
Before taking a spermogram, you must completely abandon the use of alcoholic beverages, do not visit baths and saunas. Any overheating and temperature rise will affect the number of identified male pathologies in the genitals.
So you did a semen analysis and you got bad results. The question arises if the spermogram is bad, what to do and how to treat the identified pathologies. To begin with, your attending physician should assign you a date for re-donating sperm, which is done after 2 months. The thing is that by this time the man has completely completed the renewal of his biological material.
Sterility is also an important factor in the delivery of a spermogram. The following indicators can negatively affect results:
- sterility of the vessel in which the sperm will be stored, otherwise there is a possibility of sperm death;
- the absence of acids, water, foreign bodies, lubrication after a condom, vaginal fluid in the semen, which can change the structure of the analysis.
It is for these reasons that the analysis is carried out directly in laboratories; a special sterile vessel is prepared for the liquid. Moreover, all of its inner walls should not be in fingerprints or foreign substances.
When the analysis is submitted, it remains to await the results of a spermogram, which will reveal the following main indicators and their norm:
- pH level;
- ejaculate volume;
- the number of leukocytes;
- the degree of viscosity;
- the ability of sperm to liquefy;
- the volume of rounded cells;
- sperm count per ml;
- sperm count in general.
Poor Result Actions
When receiving the results of the analysis, it is necessary to compare the existing results and the norms of indicators. For example, with minor changes in the consistency of sperm, or with a slight increase (decrease) in the pH level of the sperm count, you should consult a doctor for further treatment. These deviations from the norm affect the likelihood of conception, therefore, most often you will need to do additional tests for the presence of inflammatory processes and hormones. To achieve normal performance, it is necessary to undergo a minimum of drug treatment.
Some points in the spermogram and their decoding.
Insufficient sperm count. This means that the semen delivered contains a small amount of ejaculate, according to WHO standards, an insufficient amount begins with an indicator of less than 1.5 ml for the entire volume. Most often, the cause of this situation is previously received injuries or inflammation of the testicles, which leaves scars on the tissues.
Insufficient sperm count. A deviation from the norm is considered to be less than 12 million sperm per ml. This picture is due to an imbalance in the hormonal background. Therefore, to eliminate the inability to conceive a child, it is necessary to conduct additional examinations, and then prescribe treatment. Alas, there are situations when the cause of a low sperm concentration is the scars on the testicles. In this case, there is practically no way to fix the problem. Therefore, if you know about inflammation or trauma, you should not postpone treatment, otherwise the result will be infertility. In this case, only additional modern technologies can help, for example, IVF or artificial insemination.
Lack of sperm movement. It also happens that a spermogram indicates sperm immobility. Most often this is the result of an internal or external imbalance in the body. For example, bad habits (smoking, alcohol, drugs), constant exposure to vibrations, radiation, the presence of hereditary factors, problems with the immune system and hormonal background affect mobility.
In order to improve these and other indicators with deviations from the norms, in almost half of the cases it is enough to observe the correct lifestyle, give up bad habits, and revise your daily diet. It is not superfluous for every man who has problems with conception and male health to undergo stimulation therapy.
Treatment methods
In the treatment of infertility and male problems, all treatment consists in dividing it into basic methods and additional ones. The problem must be approached in a comprehensive manner and all causes of a bad spermogram must be eliminated.
The main methods of treatment are prescribed to influence the focus of the disease, for example, if it is necessary to adjust the hormonal background, then the emphasis is on drugs to stabilize it. In case of detecting infections in the reproductive system, the doctor prescribes antibiotics and other medicines. Also, surgical intervention, which is used in rare cases, can be attributed to the main type of treatment.
Additional treatment is carried out in combination with the main one, most often drugs of this group affect the sperm cells themselves, their number, mobility and concentration. This type of treatment restores electrolyte processes in cells, biochemical, promotes the maturation and growth of spermatozoa as a result of exposure to hormones.
One of the causes of male infertility is considered to be inactive sperm. The formation of male germ cells takes about 2 months. Sperm cells produce spermatozoa with a normal structure. The process of spermatogenesis is controlled by the hypothalamic-pituitary system. To ensure a sufficient speed of movement during their ripening, some changes occur. Chromatin loses excess proteins, the remaining ones combine with DNA molecules, which reduces the size of the cell nucleus. The cell loses most of its mass, leaving only the necessary components. If these processes are disrupted, the large size of the sperm negatively affects the speed of its movement.
The movement of male germ cells is carried out by rotating their tails, the highest speed is 30 cm / h. This allows the sperm to travel from the cervix to the fallopian tubes. The sperm cells in the body of a man are practically motionless, they move due to the movement of the muscles of the penis. They are activated after ejaculation; the secretion of the prostate gland plays an important role in giving the male reproductive cells mobility. Getting into the cervical canal of a woman, sperm are directed towards lowering acidity. Once in the uterus, the sperm are in favorable conditions, here the most stable of them can live up to 3 days. In the uterine cavity, the speed of movement of male germ cells increases.
Causes of impaired mobility of germ cells
Under the influence of various reasons, the process of sperm formation can be disrupted, they become inactive or immobilized. The formation of cells with an abnormal structure is possible. In the sperm of a healthy man, about half of the cells are characterized by reduced mobility or irregular structure. Under the influence of certain reasons, there are more of them, which affects the likelihood of fertilization. Since a mature egg cell lives no more than 24-48 hours, the speed of sperm movement is decisive in conceiving a child. Its decrease may be associated with a change in the chemical, physical, or anatomical characteristics of the sperm.
The greatest influence on sperm motility is exerted by the density of the ejaculate and the time of its liquefaction. Normally, semen has a viscous consistency; it takes 15-60 minutes to liquefy it. With an increase in the liquefaction time, sperm lose their mobility. The viscosity of the ejaculate is influenced by a substance produced by the seminal vesicles. Experts believe that it helps to keep sperm in an inactive state until they leave the body of a man. After sperm enters the woman's vagina, this substance breaks down under the influence of a proteolytic enzyme produced by the prostate gland. Therefore, immotile sperm cells are often found in men with diseases such as prostatitis and prostate adenoma.
Another indicator that indicates a decrease in sperm motility is ejaculate volume. Since sperm mainly consists of prostate secretions and seminal vesicles, dysfunctions of these glands can contribute to a decrease in its volume. An insufficient amount of secretion leads to a lack of nutrients that provide sperm motility. Increased acidity in inflammatory diseases of the genitourinary system is another reason for the deterioration of sperm quality. The acid dissolves the cell membrane and promotes cell destruction.
A great influence on the speed of movement of spermatozoa is exerted by their morphological qualities, the optimal speed of movement is determined by the size and shape of cells inherent in nature. Cells with an enlarged head, an elongated body or a short flagellum are weak, slow spermatozoa, unable to fertilize. Therefore, the concept of "inactive spermatozoa" is often combined with the diagnosis "teratospermia" - an increase in the number of cells with an abnormal structure.
When is asthenozoospermia diagnosed? A similar diagnosis is made when more than 60% of sedentary spermatozoa are found in the ejaculate. Why do immobile and flaccid sperm appear? There are many reasons leading to a deterioration in sperm quality - prolonged absence of sexual intercourse, alcohol abuse, smoking, drug addiction, electromagnetic or radiation exposure, overheating, decreased immunity, infectious diseases, testicular trauma, varicocele. Treatment begins with eliminating the cause of the decrease in the mobility of male germ cells. Spermogram results may turn out to be incorrect if the rules for sampling are violated. Before taking tests, you must not take a hot bath or visit a bathhouse. For research it is necessary to hand over material obtained through masturbation.
The main methods of treatment
The therapeutic regimen is selected depending on the cause of the appearance of sedentary sperm. In case of intoxication of the body, you should stop taking alcohol, smoking, and drug use. Drug treatment involves the use of vitamins, immunostimulants, restorative agents. Smoking negatively affects the quality of sperm, as nicotine contributes to the narrowing of blood vessels. Violation of the blood supply to the testicles affects the formation of sperm and the production of hormones. Treatment of diseases leading to the appearance of sedentary sperm cells does not give any results if the patient does not reduce the number of cigarettes smoked per day.
Elimination of inflammatory processes in the genitourinary system begins with the detection of the causative agent of the infection. Depending on its type, antibacterial, antiviral and antifungal drugs are selected. The use of proteolytic enzymes increases the permeability of cell membranes for better penetration of active substances. Treatment of inflammatory processes in the testes with the help of such drugs leads to a decrease in the severity of cicatricial changes in the tissues. This facilitates the movement of sperm through the vas deferens.
A spermogram is a study of the ejaculate, the purpose of which is to assess the state of male health and the ability to conceive, as well as to identify urological diseases in a man's body (prostatitis, varicocele, STIs, etc.).
Sperm analysis is an integral step in planning a pregnancy, and is also performed in infertile marriages, when the couple cannot conceive a child for at least a year.
Assisted reproductive technologies (IVF, ICSI), which are rapidly developing today, even with the worst indicators of sperm quality, help to fertilize an egg. Even if the reason for the couple's infertility lies in the woman's problems, the man also needs to undergo a diagnosis of ejaculate.
Preparation and delivery of spermogram
For the delivery of a clinical analysis of ejaculate, there are several very important requirements on which the result of the study will depend. These requirements include nuances:
- Sperm should be collected exclusively by masturbation, as ejaculate collected during intercourse may contain traces of the female vaginal microflora. It is also strictly forbidden to use condoms, as they are processed with spermicidal substances that affect the quality of sperm. The use of various lubricants and saliva is also prohibited.
- 2 weeks before the study, you should stop taking antibiotics and other drugs that can affect the semen analysis.
- It is best to collect semen for research in the laboratory in which the analysis will be carried out. If the sampling of biomaterial is carried out at home, then it is mandatory to observe the rules of personal hygiene and use a sterile plastic container for transporting the sample. The ejaculate must be collected at room temperature, the material should be transported strictly at a temperature of 37 degrees (in a special thermostat or just under the arm), the time from receipt to delivery of the sample to the laboratory should not be more than 60 minutes.
- It is necessary to observe sexual abstinence for at least 2 days and no more than a week. The optimal period is 3-4 days. During this period, it is also necessary to refuse to take alcohol and thermal procedures (saunas, hot baths).
- To obtain a reliable result, the spermogram must be passed at least 3 times, with a 10-day break, since the sperm has a variable composition, the quality of which is influenced by diets, medications, psychoemotional factors, and the general condition of the body.
Normal values of spermogram results and their interpretation
| Spermogram indicator | WHO standards | What does this indicator mean? |
Semen analysis |
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2-7 days | The number of days of sexual abstinence before testing |
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2 ml or more, up to 6 ml. | Semen volume for analysis |
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7,2 — 7,8 | Index of the ratio of positive and negative ions |
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40 million or more, up to 500 million | Sperm density multiplied by volume |
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Up to 60 minutes | Time to dilute ejaculate to normal viscosity |
| Grayish, grayish white | Sperm color | |
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Presence of small separate drops (formation of threads up to 2 cm long) | Sperm viscosity, which is determined by measuring the length of the filament, which is formed using a pipette or needle |
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Absent | Red blood cells |
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1 * 10 ^ 6 in 1ml ejaculate | White blood cells |
Sperm analysis |
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20 million or more, up to 120 million |
Sperm count in 1 ml of semen |
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Type A more than 25% Type A + B more than 50% Type C less than 50% Type D less than 10% One hour after ejaculation |
|
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More than ½ of the total | The number of viable spermatozoa, that is, the number of abnormal spermatozoa should not be more than 50% |
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Normally not detected | The process of sperm adhesion to each other, which interferes with normal movement |
The spermogram results, which fit into the WHO reference values, allow us to conclude that a man has normal fertility (fertility) and is capable of childbearing. Deviations from these indicators (when more than 2 spermogram analyzes are performed) in most cases indicate the presence of any pathological processes in the male reproductive system.
Thus, the morphology of sperm is practically the most important criterion in the study of sperm.
With a normal sperm concentration and a good indicator of motility, the presence of a large number of sperm with an irregular morphological structure may indicate the infertility of the ejaculate (inability to fertilize the egg or abnormal development of the fetus).
In most cases, pregnancy, which occurred with poor morphology of the partner's sperm, ends in miscarriages or fetal freezing. Increased leukocyte or erythrocyte counts require a more detailed examination, as they may indicate infectious or pathological processes.
Reasons for immobility of sperm and other abnormalities in the spermogram
Spermatogenesis in a healthy person is a continuous process, however, with various disorders in a man's body, it is destabilized. The reasons for reduced spermatogenesis include:
Endocrine Disorders
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Genetic disorders:
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Disorders of the urogenital tract:
As well as neurological disorders and birth defects of the genitals |
Use:
Exposure to high temperatures:
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Such an indicator of a spermogram as sperm immobility is a serious deviation in which the onset of pregnancy is almost impossible. When immobility or weak motility of sperm cells is detected, the following factors may be the reasons for this phenomenon:
- wearing tight underwear
- drinking alcohol, smoking
- stressful condition, strong fear
- use of intimate lubricants
- excess external heat (sauna, hot baths) and internal (high body temperature)
- electromagnetic waves and ionizing radiation
- prolonged sitting (office workers, cyclists, drivers)
- hypothermia of the pelvic organs
- toxic effects of drugs - cocaine, marijuana, hashish, etc.
- treatment with antibiotics, antimicrobial drugs
Terms for Explaining Violations
The reasons for the violation of normal sperm parameters can be both an insufficient amount of sperm and a complete absence of sperm in the ejaculate, as well as defects in sperm quality, which include immobility of sperm and their incorrect morphological structure. Various terms exist to describe sperm abnormalities:
AZOOSPERMIA - complete absence of spermatozoa in the ejaculate, but the presence of spermatogenesis cells
That is, there are not sperm in the semen, but the forms preceding them - the products of the secretion of the seminal vesicles and the prostate gland. With azoospermia, the function of maturation and division of spermatozoa is inhibited at various stages of spermatogenesis. This is one of the causes of infertility, leading to azoospermia:
- Inflammatory diseases of the male genital organs, in which the patency of the vas deferens is impaired
- Congenital (genetic) disorders
- Exposure to toxins - alcohol, drugs, radiation, the effects of various harmful chemicals, some drugs, etc.
- Other infectious and non-infectious diseases of the body.
ASPERMIA - absence of sperm in semen and spermatogenesis cells
With aspermia, there are no spermatozoa or spermatogenesis cells. At the same time, the sensation of orgasm persists, but is erased or weakly expressed, the release of fluid during intercourse consists of the secretion of the prostate gland and seminal vesicles, and the amount of sperm is very insignificant. The causes of aspermia are:
- If aspermia is due to a blockage of the vas deferens, a man needs plastic surgery to restore fertility.
- If aspermia is caused by genetic abnormalities, when the testes are unable to produce sperm (testicular aspermia), then any treatment is futile.
AQUINOSPERMIA - complete immobility of spermatozoa
Akinesia or akinospermia is a complete inability to fertilize due to the complete immobility of living spermatozoa. Why is this happening? The causes of this pathology have not been sufficiently studied, it is assumed that sperm immobility is caused by:
- Hormonal disruptions
- Inflammatory diseases of the sex glands
- Disadvantages of the analysis - hypothermia of sperm in laboratory conditions during storage, the use of a condom for collecting sperm, direct sunlight or chemicals in a test tube with sperm, and other disruptions in transportation and storage.
If akinospermia is established, the analysis should be repeated 2-3 times.
ASTENOZOSPERMIA or asthenospermia - a decrease in the number of motile spermatozoa or a decrease in the speed of movement
A decrease in the number of mobile forms can lead to male infertility, with asthenozoospermia, sedentary and completely immobile spermatozoa account for over 30%. With asthenospermia, a complete examination should be performed to establish the cause:
- Violation of spermatogenesis for all of the above reasons, as well as
- Chemical change. the composition of the sperm plasma, a decrease in energy substances, carbohydrates
- Disappearance or decrease in the negative electrical charge of sperm
- Sperm sedimentation on the surface of various microorganisms (mycoplasma infection).
Violation of spermatogenesis leads to a decrease in the number of spermatozoa and the appearance of abnormal, pathological forms that are not capable of full movement.
HEMOSPERMIA - detection of erythrocytes (blood) in semen
In the presence of blood in the semen, it acquires a rusty or red color, while the viability of the sperm remains, but this indicates a disease of the genitals:
- In most cases, this is due to inflammation and blood flows from the prostate or seminal vesicles into the semen
- Blood can also appear with oncological diseases of the genital organs.
- With stones in the prostate gland, blood enters the ejaculate from the urethra, epididymis, or vas deferens
- In case of rupture of papillomas, small varicose veins, seminal tubercle.
NEKROSPERMIA - the presence of non-viable sperm in the ejaculate
Necrospermia due to immobility of spermatozoa is sometimes mistaken for akinospermia. If dyes accidentally enter the test tube with sperm during the study, then non-viable sperm may appear in the ejaculate, in such cases, a second test is required. Necrospermia happens:
- False, that is, reversible, when revitalization of sperm is possible
- Partial necrospermia, when live sperm is less than 20%
- True, that is, irreversible - this is rare and does not respond to treatment, while IVF with donor sperm is indicated
NORMOSPERMIA or normozoospermia - normal sperm counts
At the same time, all spermogram indicators are normal, that is, spermatogenesis is normal and spermatozoa have high viability. But even with sperm motility above 70% and an amount of 60-150 million / ml, 100% pregnancy in a healthy woman is not guaranteed. Since the causes of possible infertility are sometimes psychological in nature, they can be caused by immunological factors, when the female body produces antibodies against the sperm of a particular man.
OLIGOZOOSPERMIA - a decrease in the number of sperm in the ejaculate
It is considered normal when 1 ml contains 60-150 million spermatozoa, oligozoospermia should be distinguished from oligospermia. There are several degrees of low sperm count:
- 1 - 60-40 million
- 2 - 40-20 million
- 3 - 20-5 million
- 4 - less than 5 million
The lower limit of the norm at which pregnancy is possible is 20 million in 1 ml. sperm, subject to their high mobility, fertilizing ability. If, nevertheless, pregnancy does not occur in a gynecologically healthy woman, then regardless of the degree of oligozoospermia, this is considered a pathology. Any fluctuations in one direction or another by 10-15% can be in an absolutely healthy man. Oligozoospermia can be caused by:
- fasting, vitamin deficiency
- chronic poisoning with mercury, lead, radiation, radiation, carbon dioxide poisoning
- hormonal deficiency impairing spermatogenesis
- smoking, alcoholism
- chronic genital infections (especially, mycoplasmosis, etc.)
- constant stress, physical and mental overload
- frequent ejaculation, both natural and frequent masturbation, wet dreams
OLIGOSPERMIA hypospermia, hypovolumia - a decrease in the volume of ejaculate ejected during ejaculation
In this case, the volume, at a rate of 2-5 ml, decreases to 1-1.5 ml, the reasons may be:
- different etiology
- hormonal deficiency
- genetic diseases (Klinefelter syndrome)
- stress, overwork
- malnutrition, alcohol, smoking
- aspermia and azoospermia
- frequent masturbation and sexual intercourse
If a man refrained from any method of ejaculation for 4-5 days and collected sperm without loss in laboratory glassware and at the same time reduced the volume, this is true oligospermia.
PIOSPERMIA - the presence of pus in semen
This is a clear sign of an inflammatory process in the male genitals, requiring careful examination and treatment. The semen contains microorganisms, leukocytes, cellular decay products, it has a fetid odor and a yellow-green color. Pyospermia is usually combined with oligospermia, hemospermia, teratozoospermia. Pus can be secreted from the urethra, the epididymis (especially in the tuberculous process in the male genital organs), the prostate gland, seminal vesicles. Since the toxins released during the life of bacteria damage spermatozoa, their mobility decreases, pathological forms appear and the ability of sperm to fertilize decreases.
POLYSPERMIA or multisemia, multipole - persistent discharge during ejaculation of an increased number of sperm in the ejaculate (over 250-300 million / ml)
Usually, all indicators of spermogram with polyspermia are normal, but spermatogenesis is impaired, since with high activity of the seminiferous tubules, a high% of sperm with low fertilizing ability arise. Sometimes this term is called a large semen volume up to 8-10 ml. At the same time, the couple often has miscarriages or infertility. In this case, ICSI is indicated.
TERATOZOSPERMIA or teratospermia, anisozoospermia - the presence of abnormal, pathological forms of sperm in the semen more than 50%
The causes of teratozoospermia are the same as in oligozoospermia and asthenozoospermia, that is, unfavorable environmental factors, pathological conditions that disrupt spermatogenesis. With a large number of degenerative spermatozoa during insemination with artificial sperm (according to studies), 50-60% of cases lead to miscarriages, miscarriage, that is, to severe fetal developmental disorders. Therefore, with such a spermogram result, the couple should refrain from trying to conceive, and the man should be treated by an andrologist.
How to increase sperm motility?
It is known that sperm motility depends on temperature. So, during ejaculation, the temperature of the male body rises, as a result of which the mobility of spermatozoa also increases.
That is why, for the study of ejaculate, special heated tables are used, which maintain the body temperature (approximately 37 degrees). If the spermogram is performed at a lower temperature, then poor mobility of "male cells" can be observed even in healthy young men.
Accordingly, with asthenozoospermia (immobility of spermatozoa), the possibility of pregnancy is significantly reduced. However, it does not mean at all that with an increase in sperm motility, pregnancy will occur in 100% of cases, since it is not uncommon for a decrease in mobility to be combined with other deviations.
Since low sperm motility can be caused by age, serious pathologies, chronic diseases:
- obesity, diabetes mellitus, arterial hypertension (high blood pressure)
- varicocele, testicular underdevelopment, non-prolapse of the testicles into the scrotum, impaired patency of the vas deferens
- infectious diseases of the urogenital tract, etc.
you should find out the cause, having passed a thorough examination, and treat the underlying disease.
- British scientists suggest that in order to increase sperm activity, a man needs to include in the diet an increased intake of vitamins and antioxidants, which are able to remove free radicals from the body, which in turn should lead to an increase in sperm motility.
- To improve sperm counts, it is also necessary to give up bad habits and eat properly.
- Equally important is a healthy sleep (see) and good rest.
- The dietary supplement Spermactin is recommended for men as a source of carnitine (vitamin B11), in preparation for IVF, ICSI, PE, for the correction of stage 3-4 oligoastenozoospermia, for improving the quality of sperm during cryopreservation, donation.
In conclusion, it should be noted that the results of just one spermogram are not yet a reason for a diagnosis. To confirm this or that deviation from normal indicators, a man must pass a spermogram at least 3 times. In this case, the result with the best performance is taken into account.
The most significant indicators of male fertility are sperm motility and activity. These characteristics are determined by analyzing the spermogram. To get a reliable result, it is necessary to pass several samples, since the ability of male germ cells to active movement is influenced by many factors.
What ensures the mobility of the sperm
The sperm cell is the smallest and most active cell. The speed of movement is 30 cm per hour, and given the microscopic size of the sperm, this is a very high indicator. This mobility is achieved by the sperm due to the propulsive force (pushing forward), which is provided by the rotation of the flagellum tail. It is this part that is responsible for delivering the genetic material to the egg.
But the tail does not move by itself. Nature provides for a special mechanism: the entire sperm flagellum is covered with Hv1 proton channels, which, when they enter the vagina, open in order to partially alkalize the environment. The effect of a punctured balloon arises: the channels open, protons fly out at a tremendous speed, forcing the sperm to move with acceleration. The closer to the target, the more channels open due to the reaction to a substance called "endocannabinoid anandamide", which is abundant near the egg.
Spermatozoa know in advance the desired vector of direction of movement - towards lowering the acidity of the environment
Spermatozoa know in advance the required vector of direction of movement - towards lowering the acidity of the medium. The male reproductive cell owes such "instinct" to a special apparatus - chemotaxis, which analyzes the chemical composition of the environment and gives a signal about a safe direction.
Proton channels were discovered quite recently, but the discovery of a direct dependence of the intensity of their stimulation on the pH level will help to influence the activity of sperm in male infertility. After all, good cell mobility in this matter is very important, since they need not only to leave the acidic environment of the vagina as quickly as possible, constantly fighting the oncoming flow, but also to overcome the mucous plug at the entrance to the uterus, and then make their way to the fallopian tube. In total, you need to walk about 20-25 cm.
Assessment of sperm motility
After receiving the results of semen analysis, the results are deciphered in accordance with the WHO standards established in 2010.Spermatozoa are divided into three groups according to the degree of activity (in parentheses - 1999 classification):
- The number of people moving forward at different speeds (A + B).
- The total number of mobile cells: the first group, as well as weakly mobile, making circular or oscillatory movements (A + B + C).
- Fixed (D).
In the first case, fluctuations in mobility are caused by the following reasons:
- seasonality: in the spring there is a lower sperm activity;
- circadian rhythms: in the afternoon, the mobility of the germ cells increases;
- ejaculation frequency: the more often the sperm is renewed, the more active the sperm.
All of the above does not have such a significant effect on the overall indicator as diseases:
Varicocele is the cause of decreased sperm motility in 25% of cases
- varicocele (causes a decrease in sperm motility in 25% of cases), hydrocele;
- acute and chronic urogenital infections, bacteriospermia. Many bacteria cause sperm agglutination or adhesion (eg E. coli);
- blockage of the ducts of the seminal vesicles, the vas deferens leads to a decrease in pH. As a result, sperm motility drops significantly;
- epididymitis. Spermatozoa gain mobility, moving along the epididymis - the epididymis. Its epithelium produces a factor that ensures the longitudinal mobility of the germ cells, therefore, all inflammatory processes negatively affect the ability of sperm to move fully. This also applies to mature germ cells stored in the caudal section (tail) of the epididymis before ejaculation;
- pathology of the structure and trauma of the organs of the reproductive system. Even a small injury, received a few years ago, is able to trigger autoimmune processes when antibodies against their own germ cells begin to be produced;
- endocrine disorders, metabolic disorders;
- hyperprolactinemia, antisperm antibodies.
Low sperm motility or lack of activity can be caused by congenital genetic abnormalities (rare):
- violations of the structure of germ cells, for example, the "9 + 0" syndrome, which means the absence of a central pair of microtubules in the tail of the sperm. With this disease, all the sex cells of a man are immobile;
- syndrome of "motionless cilia" - the absence of special dynein handles in the flagellum of the sperm, which ensure the connection of the tubules;
- the presence of mutations at the mitochondrial level of sperm DNA;
- Kartagener's syndrome - mutations in genes that are responsible for the formation of ciliated epithelium (the mobility of the flagella of germ cells is directly related to its functioning).
Low sperm motility caused by diseases is in most cases reversible
Low sperm motility caused by diseases is reversible in most cases. It recovers in whole or in part after surgical or conservative treatment.
An immobile sperm cell is not suitable for natural conception, but if mobility is absent due to genetic disorders or an incurable condition, then IVF is used to fertilize the egg by ICSI.
Most often, sperm activity is influenced by external factors, the effect of which can be controlled or eliminated altogether. Electromagnetic fields, lead, heavy metal salts, narcotic drugs, accumulation of cadmium in the ejaculate can reduce mobility. All this pathologically changes the structure of sperm flagella. But there are also simpler reasons leading to a deterioration in cell activity.
Temperature
Sperm are sensitive to temperature changes, since the testes are located on the outside of the peritoneum and are subject to external influences. Overheating is especially negative. If a man likes to spend a lot of time in a bath or a hot bath (more than once a week), then the sperm activity will steadily decrease. The same effect is exerted by heated car seats during long trips and the like. When the temperature rises above 39 degrees (for example, with the flu), there is a complete immobility of spermatozoa and even their death.
Another factor affecting mobility through a violation of thermoregulation is an inguinal hernia. If its size is large, and the protruding part of the intestine has already descended into the scrotum, then not only a loss of sperm activity is likely, but also complete testicular atrophy.
Smoking and alcohol has an extremely negative effect not only on mobility, but also on other indicators of spermogram
Alcohol and smoking
Smoking and alcohol are the causes of intoxication of the body. This is what affects extremely negatively not only mobility, but also the rest of the spermogram indicators. The decay product of alcohol penetrates into all cells, including the reproductive cells. Regular toxic exposure unbalances the endocrine system, inhibiting the production of testosterone and other hormones.
Some believe that they do not harm their body, because they smoke only "natural drug" - marijuana. Studies have proven that the substances contained in marijuana disrupt the structure of the sperm flagellum, thereby completely immobilizing it.
Medications
If a man is forced to undergo therapy with cytostatics and steroid hormone blockers for a long time, then the percentage of active spermatozoa drops significantly. Anticonvulsant, psychotropic, antihypertensive drugs, antibacterial drugs, antibiotics have a negative effect.
Nutrition
Sedentary sperm cells are often the result of poor nutrition. Harmful foods and drinks:
- any fast food;
- canned food;
- large quantities of coffee, cola, strong tea, including green;
- spicy, salty dishes;
- industrial lemonade;
- fatty and fried foods.
Sedentary sperm are often the result of poor nutrition
1-2 months after excluding these products and switching to a balanced diet without the use of any additives, sperm activity increases significantly.
How to improve your mobility score
If asthenozoospermia is not too pronounced (the percentage of motile sperm is slightly below normal), then there is no reason for concern. In this case, the doctor does not offer additional examinations, but advises to adjust the diet, lifestyle and retake the spermogram in a month.
In some cases, vitamins are prescribed:
- zinc in the form of citrate (its amount in semen has a direct effect on motility);
- magnesium;
- selenium;
- group B;
- A, D, E ("Enat").
Also popular are supplements with L-kartitis, which have a positive effect on mobility:
- Spermaplant;
- Spermaktiv;
- PROfertil.
Popular L-kartitis supplements such as PROfertil
Phytopreparations (Speman, Tribestan), decoctions of plantain seeds, elecampane roots, rose hips are used.
Even a frankly bad spermogram improves after a couple of months when taking beekeeping products: bee bread, propolis, drone milk.
It is important to adjust the diet, giving preference to white meat, fish, cereals, vegetables and fruits. Greens are useful, especially parsley and dill.
Physical activity should be regular but moderate. Overstrain in the gym will lead not only to a temporary decrease in sperm activity, but also to the development of varicocele and inguinal hernia.
If the lack of mobility is pronounced or accompanied by deviations of other indicators, then studies are assigned to find out the reasons, for example:
- blood test for hormones, antibodies;
- bacterial culture of prostate juice and sperm;
- TRUS, ultrasound of the testicles.
Based on the results obtained, the treatment regimen is determined. When obstructions, bacterial foci and inflammations are eliminated, sperm activity will increase after a while.
It is not for nothing that clinics have a program for preparing for the delivery of ejaculate:
- abstinence from sexual intercourse for 3-4 days;
- giving up alcohol for 2 weeks;
- avoid stress, overheating, overwork;
- adherence to a diet;
- quitting smoking if possible.
All these factors directly provoke poor sperm motility. The spermatogenesis cycle averages 72-75 days. To get the most reliable indicator of mobility for the body, it is advisable to observe the above rules during this time.
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A healthy man and woman, not using contraception, can conceive a child in about six months. In about 30% of cases, pregnancy occurs within a year. But if the planning is already taking longer, but the result is not, the spouses are advised to check the state of their reproductive health.
In about 40% of cases, the reason for the absence of pregnancy lies in low sperm motility. How it is determined and whether it can be improved will be discussed in this article.
What it is?
Due to such a property as mobility, male reproductive cells can move along the female genital tract to the egg, which "waits" for them after leaving the follicle in the fallopian tube.
Ovulation calculator
Cycle duration
Duration of menstruation
- Menstruation
- Ovulation
- High probability of conception
Indicate the first day of your last period
Ovulation occurs 14 days before the start of the menstrual cycle (with a 28-day cycle, on the 14th day). Deviation from the mean is common, so the calculation is approximate.
Also, along with the calendar method, you can measure basal temperature, examine cervical mucus, use special tests or mini-microscopes, take tests for FSH, LH, estrogens and progesterone.
It is possible to unambiguously establish the day of ovulation by means of folliculometry (ultrasound).
Sources:
- Losos, Jonathan B .; Raven, Peter H .; Johnson, George B .; Singer, Susan R. Biology. New York: McGraw-Hill. pp. 1207-1209.
- Campbell N. A., Reece J. B., Urry L. A. e. a. Biology. 9th ed. - Benjamin Cummings, 2011. - p. 1263
- Tkachenko B.I., Brin V.B., Zakharov Yu.M., Nedospasov V.O., Pyatin V.F. Human physiology. Compendium / Ed. B.I.Tkachenko. - M .: GEOTAR-Media, 2009 .-- 496 p.
- https://ru.wikipedia.org/wiki/Ovulation
This path on a cellular scale is rather long and difficult. Only the most hardy and mobile sperm reach their destination.
Mobility depends on many factors: on the density of the semen, on the morphological properties of the sperm itself. A cell with a normal structure is more likely to be fast and dexterous than a cell with deformities of the tail or head, and abnormalities in the thickness of the sperm neck. By itself, the tail of the sperm does not move; without external influence, the cell will not move anywhere.
The covering of the tail is a proton channel. As soon as the ejaculate enters the vagina, the environment in which, it should be noted, is quite aggressive, the channels open and protons are released. Their task is to reduce the acidity of the vaginal secretions. By itself, the ejection gives the reproductive cell a certain acceleration and makes the tail move.
The sperm cell exactly "knows" that he needs to swim to the place where the acidity is lower, that is, inside the uterus. A special system of analyzers of acidity, which sperm have at their disposal, "prompts" the right direction.
It should be noted that proton channels were discovered quite recently. For quite a long time, doctors believed that the tail is mobile by itself, by nature.
It is possible to establish the mobility of the sex cells of a man only in laboratory conditions during a special analysis - spermogram. All spermatozoa, being inside the gonads, are completely immobile. When ejaculation occurs, they (under the influence of a special protein) are freed from the thick environment and gain freedom of movement.
The more active sperm a man has, the more likely he is to become a dad.
Sperm types and conception prognosis
The ability of male germ cells to move is assessed according to strict criteria. Depending on them, all sperm are divided into four large groups.
- Group A... These are the most active cells that are best suited for fertilization of the female egg. They only move straight ahead at speeds up to 25 micrometers per second. In the classification of physicians, they are called progressive or active-mobile.
- Group B... These are also quite mobile and active sperm, which differ from the representatives of group A only in that their speed is slightly lower. However, they also move straight. These sperm are also suitable for conception.
- Group C... Such germ cells do not move at all the way they need to for a successful conception. They either move, staying in place, or "travel" along a circular path, or move along a broken line, in a zigzag. The classification classifies them as non-progressive and mobile. Conception with the participation of such cells is unlikely.
- Group D... The last group includes sperm cells that do not move at all. They are called non-progressive-immobile. The chances of conception with D sperm are nil.
A man's sperm is considered suitable for fertilization if it contains at least 25% of the cells of group A. at least 50% of the total number of germ cells in the ejaculate.
The notorious human factor and laboratory errors are excluded, because it is not a person who counts, but powerful sperm analyzers, which produce a finished result with microscopic accuracy.
The less cell motility, the more difficult it is to get pregnant. The probability of conception is calculated based on the exact proportions.
If the ejaculate contains 60% of the cells of group C, then the probability of spontaneous conception is about 3%. If the number of cells in group D exceeds 70%, natural conception becomes almost impossible.
In most laboratories, the number of sperm in groups C and D is not counted at all, limiting itself to the allocation of a percentage of A and B cells. In case of a deviation from the norm, a man is diagnosed with asthenozoospermia. This is a form of male infertility and it definitely needs treatment.
Causes of inactivity
To establish the cause of the low mobility of male germ cells, the MAP test allows. It is by its results that one can judge the fertile abilities of a particular man. It should be noted that sedentary and immobile sperm are present in all. The only question is their mass fraction.
In a man who is faced with sperm dyskinesia, the question naturally arises as to why this happened to him. The reasons that cause a decrease in the activity of germ cells are conventionally divided into three types:
- pathological, caused by diseases;
- external;
- natural (physiological).
The natural reasons for the decrease in the activity of male reproductive cells are temporary and do not need treatment. Most often, sperm become inactive and less active in the spring. During the day, the mobility of germ cells is also not the same: in the morning, sperm are less active than in the evening. Much also depends on the frequency of intercourse or masturbation. If a man is sexually active, the composition of his sperm is updated more often, which means that sperm will be more active. Men who abstain for a long time cannot boast of motile and active sperm. These reasons are easy to correct, they are not considered pathological.
Pathological causes are most often associated with diseases of the reproductive system: prostatitis, varicocele. Often, the true cause of low mobility lies in bacteria, such as E. coli, if found in the ejaculate. Bacteria lead to agglutination (adhesion of cells to each other), as a result of which mobility is lost. The problem may lie in the vas deferens, especially if there is a blockage of the seminal vesicles.
Inflammatory processes in the male reproductive system almost always lead to a decrease in sperm activity. The most dangerous from this point of view is epididymitis. Inflammatory ailments of the epididymis directly affect the spermatozoa, which before ejaculation are "stored" in a certain part of this epididymis - the epididymis. Dangerous for male health and sexual infections, including ailments, the course of which is sometimes imperceptible: chlamydia, ureaplasma and the like.
Sperm motility can be reduced due to autoimmune processes. If there was an injury, even a minor one (for example, a blow to the groin during a fight), an immune process may start, during which antisperm antibodies will be produced, which will suppress and destroy living and active spermatozoa, "confusing" them with foreign cells. Also, hormonal imbalance, problems with the thyroid gland, adrenal cortex, as well as excess weight can adversely affect.
It is quite rare in men that congenital pathologies are found, for example, the "9 + 0" syndrome, in which a pair of microtubules is initially absent at the genetic level in the tail of the sperm, as well as sperm DNA mutations. In most cases, with genetic pathologies, the sex cells are completely immobile, and the man is completely sterile. In this case, only artificial insemination of his wife using donor sperm can help him become a dad.
External reasons for a decrease in the activity of male sex cells most often lie in common male mistakes. If a representative of the stronger sex is very fond of visiting the bathhouse and basking in a hot bath for a long time, his testicles overheat, which leads to the appearance of a large number of sedentary or immobile spermatozoa.
Those who like to drive a car in a warm, electrically heated seat also run the risk of having problems conceiving. Overheating of the testicles also occurs at high temperatures, if, for example, a man is ill with the flu or SARS. After healing, it takes about three months for the sperm to renew their composition, and the dead cells are replaced by live and active ones.
Bad habits, smoking and alcohol, even in small quantities, but with a systematic intake, have a destructive effect on the germ cells. Not only their mobility is impaired, but also morphology, which not only reduces the ability to fertilize, but also increases the likelihood of conceiving a child with chromosomal abnormalities.
Narcotic substances act on sperm in a similar way. Marijuana is famous for its paralyzing effect on the sperm flagellum. Therefore, an experienced smoker may have difficulty reproducing offspring.
Both antibiotics and anticonvulsants reduce sperm activity. Hormones have the most detrimental effect on them, it is for this reason that young and strong athletes are often infertile - the passion for steroid hormones cannot pass without a trace for reproductive health.
Those who like to dine in fast food restaurants are also at risk for asthenozoospermia. Any fast food, soda, canned food contains a large amount of preservatives and dyes that destroy the structure of sperm cells. Negatively affects the composition of the semen and the habit of drinking a lot of coffee.
Reduced sperm activity can be in men who work in hazardous industries, have constant or long-term contact with heavy metal salts, varnishes and paints, radioactive radiation. Also, asthenozoospermia "lurks" men who are very nervous and are in a state of chronic stress.
How to increase mobility
Timely and correct treatment will help to increase the chances of conception. Fortunately, in most cases (both pathological and external), the mobility of germ cells can be restored or at least improved. Today, there are several ways to activate sperm.
Traditional medicine
With a slight decrease in mobility, doctors try not to prescribe serious therapy, limiting themselves to recommendations for correcting lifestyle and nutrition. Sometimes it is enough to eat normally for a month or two, avoiding fast food and alcohol, lead an active lifestyle, sleep at least 8 hours a day, change your "harmful" work for a safer one. Repeated spermogram (in most cases) shows a noticeable improvement, pregnancy occurs as soon as possible.
As soon as a man eliminates the external negative influences, which were listed above, his reproductive health will recover and the germ cells will become much more active.
To improve sperm motility, men are prescribed drugs to increase the intensity of spermatogenesis. These include vitamins A, E, C, D, zinc, selenium, iron, and folic acid. These drugs can be taken separately, or as part of a balanced and specially designed complex for men. Additionally, tablets and capsules are recommended, which belong to dietary supplements and antioxidants and have a positive effect on the composition of the ejaculate. These drugs include Spermaktiv, Spermaplant, Proffertil and others.
