Post Date December, 03 2023
The semen test is generally conducted in three steps.
Step 1: Check the semen routine, check the overall semen condition, and help doctors find the direction to further find the cause;
Step 2: Examine the in-depth aspects of semen according to the characteristics of the disease: such as infection indicators, trace elements, antibodies, DNA fragments, acrosomal analysis, etc;
Step 3: Further, genetic issues may need to be considered, such as chromosome and Y chromosome microdeletions.
This is like enemy investigation or map zooming in, which requires step-by-step in-depth and progressive analysis based on the significance of each of the following inspections and the principles of individualization. Therefore, it is particularly important to remind patients that they need to buy a plastic hard skin document bag to protect each item and each examination result (regular hospitals have standardized procedures, combined with the unique experience of doctors). It takes sufficient time to see infertility, and the data must be kept back and forth for medical analysis. In addition, sperm testing requires abstinence for 3-7 days, so you can directly go to the ordinary simple outpatient clinic for a check-up.
What do semen tests include? What is the purpose of each inspection?
Semen routine: semen color, quantity, sperm concentration, semen liquefaction time, semen pH {PH}, sperm motility (percentage of forward-moving sperm or grade a+b sperm), survival rate and morphology, and round cell concentration.
Objective: To understand the general condition of semen and preliminarily determine whether there is "hostile situation" or what aspect it may be.
Seminal plasma biochemistry: mainly including neutral α- Glycosidases and fructose, carnitine, acid phosphatase, and lactate dehydrogenase.
Objective: To help understand the functions of the epididymis, prostate, and seminal vesicle. neutral α- Glucosidase and fructose reflect the secretory function and patency of the epididymis and seminal vesicle, respectively, and are suitable for azoospermia or severe oligospermia patients suspected of having obstruction of the vas deferens; Seminal acid phosphatase is a marker of prostate function, which is of great significance for patients with poor semen liquefaction; The detection of lactate dehydrogenase in seminal plasma is a key enzyme for sperm motility and capacitation, which can assist in judging sperm quality and predicting sperm fertility.
Sperm acrosome analysis: mainly including sperm acrosome integrity rate and sperm acrosome enzyme activity analysis.
Objective: To some extent, it reflects the ability of sperm to fertilize egg cells, and is suitable for infertile patients with unknown causes, who are preparing for artificial insemination or in vitro fertilization.
Semen infectivity index: seminal plasma elastase test and semen leukocyte staining; Relevant microbiological examination
Objective: Elastase is a protease secreted by neutrophils in the lobulated nucleus during inflammation, and is a marker of inflammation in the male reproductive tract. By combining this test with semen leukocyte staining, it can be determined whether there is genital tract inflammation; The concentration of round cells in semen is also considered to be one of the indicators of semen infection; Understand whether there are urinary and reproductive system infections and related pathogenic microorganisms (bacteria, viruses, spirochetes, mycoplasma, chlamydia, etc., commonly including gonococci, papillomavirus, adenoplasma, chlamydia trachomatis, etc.).
Detection of antisperm antibody (AsAb): The main test method is the semen mixed antiglobulin test (MAR test).
Objective: To detect infertile patients with poor sperm motility, high sperm agglutination, or unknown causes.
Sperm nuclear DNA fragment analysis: Analyze the proportion of sperm with DNA fragments in the sperm nucleus.
Objective: It is suitable for infertile patients with unexplained abortion and embryo suspension on the female side, as well as infertile patients preparing for in vitro infant treatment. Due to the high rate of DNA fragments in the sperm nucleus, it indicates that the proportion of sperm with DNA fragments in the sperm nucleus is too high, which may affect sperm egg binding, embryo quality, etc.
Analysis of trace elements in seminal plasma: The most common are zinc detection, phosphorus, etc.
Objective: To apply to patients with insufficient sperm motility and high deformity rate. Zinc, as a cofactor of more than 100 enzymes in the body, is an essential and important element related to human growth and development, and is closely related to the metabolic activities of the reproductive system. The detection of seminal plasma zinc has certain guiding significance for the treatment of male infertility.
Chromosome and Y chromosome microdeletions: Generally, in two cases, it is also necessary to check the chromosome: the male has multiple routine semen tests.
Objective: To investigate whether there are congenital factors in male infertility patients, suitable for sperm density less than 10 million/ml; Have a medical history of two or more spontaneous abortions, especially early miscarriages (within 3 months of pregnancy).
If the tests are normal, is it basically confirmed that the man has no problems?
"If the male partner's semen tests are normal, and their sexual life is normal, and the sexual life time is reasonable (reasonable cohabitation: starting the day before ovulation, having sex every other day, for three consecutive times, generally covering the ovulation period; having regular sex 1-2 times a week, and not" promiscuous "for the sake of fertility), chromosome and Y chromosome microdeletions, and thalassemia gene mutations, and other genetic tests are also normal,", Although it cannot be confirmed that the male partner's fertility is absolutely normal, this is the focus of screening that should shift to the spouse; If both parties are normal, further analysis may be required.
If it is abnormal, further analysis and diagnosis are needed in the direction of the abnormal indication.
