It is generally recommended to give a semen sample after 3-7 days of sexual abstinence. In normal men, semen volume increases by 0.4 ml and semen concentration increases by 10-15 million/ml in each daily sexual abstinence, and this increase continues for up to 5 days. Sperm motility and morphology are not affected in 5-7 days of sexual abstinence. After a week, a slowdown in motility occurs.
The most suitable semen sample is obtained by masturbation in the laboratory. The semen sample should be taken in specially prepared rooms in the laboratory. All necessary cleaning facilities, suitable heat and sound environment should be provided here. Wide-mouthed containers are used for sampling. These containers should not contain detergents and other harmful substances and should be at body temperature.
The color of semen is matte white. Depending on the duration of sexual abstinence and infection, the color may be yellowish or gray-cream. Immediately after ejaculation, semen coagulates rapidly from its liquid state. This transition occurs in a very short time. The pH value of the normal ejaculate varies between 7.2 and 8.0. It can be detected above pH 8.0 in acute prostate, vesicle seminalis, epididymal infections. In chronic infections of these organs, the pH can be detected below 7.2.
In a normal semen sample, liquefaction occurs in approximately 10-20 minutes at 37°C. This event depends on the enzymes secreted from the prostate. Liquefaction is an indicator of normal prostate function. After liquefaction, semen appears homogeneous in structure and color. If liquefaction does not occur at all or lasts longer than 30 minutes, this is an indication that the prostate 26 is not functioning normally, possibly due to previous prostatitis. Liquefaction time is important for the motility of spermatozoa.
Viscosity means resistance to semen fluidity. Proteolytic enzymes that initiate liquefaction are found in the prostate and substances secreted from seminal vesicles coagulate semen. Insufficient liquefaction leads to hyperviscous semen. High viscosity affects sperm negatively. In particular, it can affect motility, concentration and antibody coating of sperm.
Number: The lower limit of sperm count for fertility is 15 million/mL. Values below this are classified as oligozoospermic, and values below 5 million/mL are considered severe oligospermia. The absence of sperm in the semen sample is called Azoospermia. The total sperm count is simply obtained by multiplying the sperm volume by the sperm concentration. When calculating the concentration, the reconstituted semen sample can also be used in Makler counting chambers, which are specially produced for sperm count under a microscope with x400 magnification and allow counting undiluted. These special chambers are often preferred as they allow detection of motility and morphology at the same time.
Motility: Sperm motility is the percentage of motile sperm in the total sperm population. The World Health Organization evaluates mobility in 3 classes: a) Progressive (progressive) movement b) Non-progressive (non-progressive) movement c) Sedentary
Morphology: Sperm morphology reflects the quality of spermatogenesis, classified according to abnormalities in the sperm’s head, neck, and tail. According to the criteria stated by Kruger in 1988, the head should be in a flat oval shape, the width of the head should vary between 3/5 -2/3 of its length, and the length should be between 5-7 µm and the width between 2.5-3.5 µm. The acrosome should make up 40-70% of the anterior part of the head. If it is borderline normal head shapes and/or close to oval shape, this should be considered abnormal even if there is no gross deformity. The middle part should be cylindrical and connected in the direction of the long axis of the press. Its width should be approximately 1 μm and its length should be 1.5 times the length of the head. Cytoplasmic remnants exceeding ½ the size of the head or more than 3 in number should be considered abnormal. The tail should be smooth and slightly thinner than the middle, and should not be twisted or twisted. Its length should be 45 μm. According to this evaluation, the percentage of sperm with normal morphology was accepted as 4%.
aspermia : There is no ejaculate at all. Causes: retrograde ejaculation, hormonal disorders and erectile dysfunction.
Azoospermia : It means the absence of sperm in the ejaculate. Causes of azoospermia include genetic disorders, hormonal changes, germinal aplasia, bilateral absence of vas deferens and obstructions in the ejaculatory ducts.
Oligozoospermia : Sperm count is below 15 million/ml. Although the most common cause of oligozoospermia is idiopathic; systemic infections, chromosomal disorders, undescended testis, drugs, smoking and chronic systemic diseases.
Asthenozoospermia: It means that the forward motile spermatozoa are below 40% or the forward motile spermatozoa are below 32%. It can be caused by many congenital causes, infection, medication, smoking and varicocele.
Teratozoospermia: It is the condition that the morphology of normal spermatozoa is below 4%. Causes of teratozoospermia include chromosomal disorders, toxic substances (eg, smoking), varicocele and epididymal infection.
Asthenoteratozoospermia:It is that both motility and morphological examination of sperm are below normal limits.
Oligoasthenoteratozoospermia: In the number, motility and morphological examination of sperm, all three are below normal limits.
Necrozoospermia: It means the presence of more than 25% dead sperm cells in the ejaculate. It can be idiopathic; It can also occur due to contact with toxic substances, Kartagener’s Syndrome and a decrease in the frequency of sexual intercourse.
Hypospermia: It is the condition that the volume of the ejaculate is less than 1.5 ml. Causes of hypospermia include prostate, seminal vesicle and vas deferens infection, trauma and tumors as well as; androgen deficiency, obstruction of the ejaculatory ducts, and retrograde ejaculation.