STEP 2. UNDERGOING SPERMOGRAM

This is, on the one hand, the simplest, yet, on the other hand, the most complicated test. It is, however, ALWAYS a number 1 test when diagnosing the reasons behind infertility. To ensure the representativeness of your sperm sample, you have to abide by the following rules:

• You should undergo a sperm analysis at the very department where the test is to be performed. It is highly inadvisable to bring your sperm from home tucking it under the arm or having put it into a woollen sock et cetera, since it can distort the actual quality of the material.
  
• You have to abstain from sex for 2-4 days.
  
• You should not be taking any of the following medications that can affect the quality of sperm:
  

1. Anabolic steroids;
   
2. Tetracycline, Erythromycin;
   
3. Nitrofurantoin;
   
4. Calcium channel blockers;
   
5. Beta- and alpha-blockers;
   
6. Cimetidine;
   
7. Serotonin reuptake inhibitors;
   
8. Glucocorticoids.
   

The withdrawal of these medications for 3-4 days will not change the situation. Ideally, man should be free of any of these substances over a period of 3 months.
There should be no strong alcoholic beverages, saunas, steam baths, straining physical activities, neuropsychic exhaustion and sleep deficiency within 2-3 days prior to the test.
The sperm analysis will take the embryologist about 2-3 hours, after which a form sheet with the analysis findings will be given to you. It will look something like this:

Now here comes the interesting part…

The 2010 WHO review of reference values for sperm analysis gives a clear definition of the parameters and their lower reference limits:

• Sperm concentration in 1 ml – no less than 15 mln;
  
• Total sperm motility – a+b = 32%;
  
• Kruger sperm morphology - no less than 4%.
  

In this test, it is important to understand that man is a living being and cannot produce the same results over and over.
That is why, having obtained the sperm analysis results, the doctor has to give you as well as himself answers to the following questions:

• Do the results pertain to the norm?
  
• Can this sperm cause pregnancy in the outpatient setting, i.e. in the course of a natural sex life?
  
• Are any additional tests needed to find the cause of pathospermia?
  

Undergoing spermogram at different laboratories more than twice, comparing results, building curves of improvement or deterioration in quality of sperm may be captivating but has no sense whatsoever. Even more so, considering that not so many laboratories use the recommended normative values in their work.
You must have noticed that the sperm analysis findings do not include the MAR-test results. In fact:

Thus, running a blood or sperm test for AsAb (antisperm antibodies) will not bring us any closer to our goal.

On the other hand, the detection of a marked decrease in the quality of sperm calls for a careful examination of man's overall health as well as for the performance of some additional tests.