Normozoospermia means normal sperm. When semen shows normal characteristics in a seminogram, it’s diagnosed normozoospermic.
The volume of the sample must be over 2 ml, it must contain over 20 million sperm/ml, 25% of which must have good motility and at least 4% must look normal.
As specialists in infertility, we’ve been warning about the gradual worsening of sperm quality for years. Thus, the day in which a patient analizes his semen for the first time has become a very important day. They’re usually nervous and want to do everything that’s in their hands for it to be a success.
They receive the following instructions: semen must be obtained through masturbation. The sample must be handed in within a sterile container that can be purchased at a chemist’s (same container as the ones used for urine samples), trying to collect the whole ejaculated matter. It must be left at the clinic within an hour after collection. Sexual abstinence is advised during the previous 3-5 days.
The adventure begins.
How the sample is obtained… It may seem obvious but let me clarify it a bit more, just in case as we don’t want any surprises further on… For instance, it’s not uncommon we see samples that look like a crime scene under the microscope: a sperm massacre by spermicide because the patient has used a preservative.
How to seal the container… Many want to ensure the sperm won’t escape so they thoroughly wrap it up in cellophane and some even secure the lid with sticking plaster. The treasure’s packaging is important and here patients let their creativity take in. Some bring them covered in the most beautiful aluminum wraps or in colorful bags from places where they buy their food, clothes, etc. Whenever we’ve conducted studies on young population some have even brought their samples in jars of jam and very narrow test tubes (how did they ever aim it in there!?)
How to carry the container… If the sample is brought to us by car, the typical question that rises is whether they should have heat or air conditioning on. It certainly doesn’t affect the sample. Once, a patient who brought it by motorcycle had it in his pocket and it fell – his sperm happened to land all over the front glass of the car behind him.
How to bring it on time… Patients ejaculate and sprint to us it before an hour goes by. When they finally reach the clinic, they’re surprised we don’t pick it up and run to the lab as if it were a relay race. They’re always grateful we don’t look into it as they feel they’ve performed poorly and the sample’s too small. It’s true, 2-5 ml take up very little space! It’s a very common question: should I be filling it more? The answer lies in sperm’s quality, not quantity. The liquid is produced in seminal vesicles and in the prostate and its merely a vehicle for spermatozoids. We do know good sexual stimulation will give place to a better sample.
How to prevent samples getting mixed… This worries both patients and us. We always ensure the tag on the container reads the patient’s name in front of him and check whether his face matches the photo of him we keep in his medical history. Whenever the wife brings the sample, she must also bring a signed consent form from the male. Additionally, the lab also undergoes strict controls which include a biologist acting as a “controller”, checking all the identifications. The rest of the team can only continue to work when they’ve received his approval.
How will I be sexually aroused in a hospital… Worried because his wife is in an operating room meanwhile, the man believes she’s gone through a whole medical process whilst he “only” must give a sperm sample and he fears to fail. Rooms are equipped with erotic visual supplies and despite their fears they’re usually successful, and they’re also fast! Us women who work in this area are surprised that the average time is 5 minutes! Nevertheless, some get stuck and can’t perform. There’s a procedure for these cases: first, we must know whether it’s erection or ejaculation he can’t achieve. Then, treatment is applied before a second attempt: if he doesn’t achieve erection we give him Viagra-like pills, while if they can’t ejaculate we try to relax them by letting them take a walk in a nearby park or with Valium-like pills. If they stil can’t achieve ejaculation, the procedure includes Plan B, which is the aspiration of sperm from the testicle (a very simple intervention).
Finally, I’d like to comment on some issues related to the sexual abstinence on the previous days. The standard for a seminogram are 3 to 5 days, though the number is simply an attempt to reflect reality as it’s the average frequency with which couple have sex. Nevertheless, when the sample is handed in for treatment, we give less importance to previous abstinence because the male who hasn’t ejaculated for days ejaculates a greater volume but old and dead sperm are gathered in it, and thus, DNA fragmentation is worse. Additionally, ICSI requires very few spermatozoids.
Hence, you can imagine their great relief when the adventure reaches its end and the report reads “normozoospermia”!