The basic test to evaluate male fertility is performed by means of a semen analysis. This technique allows evaluating the semen sample to determine if the parameters obtained are within normality.
In 2010 the World Health Organization (WHO) established new parameters of normality based on the evaluation of thousands of samples of healthy men who had achieved a pregnancy in the previous 12 months.
The sperm analysis should be performed on an sperm sample, normally obtained by masturbation, after a maximum abstinence of 3-4 days to allow its correct evaluation.
The main parameters we need to evaluate are volume, pH, total concentration and per milliliter concentration of sperms, mobility, vitality and morphology of sperms.
If we find important abnomalies, such as a total absence of sperms, the analysis should be repeated after a few weeks, in order to confirm the diagnosis.
It is important to emphasize that spermatogenesis lasts 3 months, so that two sperms samples separated in time can give highly different results, and therefore a single semen analysis does not allow a 100% determination of fertility or infertility in a man.
The 2010 normal values are:
|Total concentration||≥39 millions|
|Concentration par ml||≥15 millions/ml|
|Progresive motility (a+b)||≥32%|
These WHO reference values serve to guide the diagnosis and treatment of the couple who do not achieve pregnancy spontaneously but do not imply that a male with results within the normal ranges is necessarily fertile or a male with results outside the normal range is completely sterile.
The individualized evaluation of each couple will make it possible to establish an adequate diagnosis and a precise treatment.
Likewise, alterations in the seminogram can make us suspect pathologies in the male in prostate, testicular and even genetic level, allowing adequate treatment and guidance.