Sperm count is a microscopic examination in a laboratory which allows us to find the quality of sperm, i.e. fertility. Sperm count is performed when a couple has problems with conception or when a man himself decides to donate sperms. The examination is composed of a removal of sperms, specialist´s evaluation and consultation with patient.
Sperms or semen has two main components. Cell component contains sperms and non-cell component is represented by the fluid part of sperm. It is essentially for men´s fertility that the creation of sperms runs smoothly and that the fluid in which sperms are preserved, has the right quality. Sperms arise in convoluted tubes of testes from germ cells in which spermatogenesis occur. During this process the germs cells are intensively divided until they become gamete, i.e. sperms. The whole process lasts for 72 days and for the appropriate course a lower temperature than the temperature of the body is necessary, what is disposed by nature by localisation of testes in a scrotum, i.e. in a leathery sac below the penis, and by sufficient amount of male hormones, especially testosterone. The fluid, in which sperms are stored in the testes, has the basic nature and contains many minerals, vitamin C, carbohydrates and proteins. The function of this fluid is to nourish sperms and protect sperms from the acid environment after the entry of sperm into a vulva.
If the course of creation, storing and transfer of sperms is distorted, impairments of infertility develop. Infertility is defined as an inability of a couple to conceive a child within two years during regular unprotected sexual intercourse. The causations of male infertility can be hormonal impairment of regulation of sperms creation, functional impairments of tissue in testes in which sperms are formed, impairments of immune system during which the immune system forms antibodies against its own sperms, erectile and ejaculation dysfunction or absence of sperms in the semen which man may not even noticed, for example, due to occlusion of the deferent canal , through which sperms are transported into the urethra and then out of the body. Unhealthy lifestyle, the environment, use of certain drugs, and excessive sauna and hot baths which warm the testicles, have also the effect on fertility. The way of treatment is chosen according to the cause of infertility which is confirmed by sperm count. However, if the treatment has not a positive effect, the methods of assisted reproduction are offered to patient.
Course of Sperm Count
Sperm count is performed in centres of assisted reproduction. Sperm sample is collected from the male through masturbation. Before sampling it is necessary that the man comply with at least 2-3 days of sexual fast to avoid skewed results. The man´s sperms are collected into a special sterile container in privacy in the collection room of the centre of assisted reproduction. The rooms are equipped with a television with DVD player together with saucy movies and men's magazines for pleasant moments. After collection, the container with the semen sample is given to laboratory for immediate examination.
Evaluation of Sperm Count
A basic evaluation of sperm count is performed macroscopically and microscopically. Macroscopic examination examines the total volume of the semen, its colour, viscosity, time of condensation and pH. The number of sperms in one ml of semen is determined by microscopic examination, it also determines their shape, size, presence of antibodies, the content of fructose, i.e. a sugar which provides energy for the sperm in 1 ml and quality of sperm. The total volume of ejaculate is normally around 3-5 ml. pH should be in the slightly alkaline values. But the most important is the number and quality of sperm. 30 to 50 million sperms should be in 1 ml of semen. Here applies the more, the better. The lower limit for fertility is 20 million sperm per one millilitre of semen. Further, the percentage of living sperms is evaluated during sperm count (at least 75%), the percentage of healthy developed sperms (at least 30%) and sperms motility in which we evaluate both velocity and direction of movement.
Interpretation of Sperm Count
After interpreting the sperm count a couple is invited to a meeting with an expert who will explain their test results and recommend further possibilities to them. It is important to realize that when a man has low amount of sperms, it does not mean that he cannot be a father. Artificial insemination or assisted reproduction is recommended to these couples. One of these methods is intrauterine insemination (IUI) where the sperms are injected directly into the woman's uterus, which increases the chances of getting pregnant due to the shortage of the long journey of sperm to an egg. Another method is intracytoplasmic sperm injection (ICSI) in which the best viable sperm is selected and injected directly into the egg taken in advance from a partner. Thus fertilized egg is then injected into the woman's uterus. For men who do not have any sperms in ejaculate, it is now possible to remove sperms by microsurgical technique directly from the epididymal duct where the sperms clump or from testicular tubules where their creation is done directly.