What should be spermogram for IVF in normal and how to improve performance?

If a couple is to have IVF, then preparation for it requires serious. Both men and women have to do a lot of tests, as well as donate their biomaterial, since fertilization will take place outside the maternal organism. The woman takes the egg, and the man gives the sperm, from which the laboratory technicians will allocate the healthiest and most mobile sperm for subsequent fertilization.

Before donating, sperm must be examined, a spermogram is made. What are its norms, if IVF is to be done, and whether it is possible to improve the composition of seminal fluid before the procedure, we will describe in this article.

Spermogram is a laboratory microscopic and hardware study of the quality of ejaculate. Before in vitro fertilization, this analysis is always done regardless of the factor of infertility. If a woman is barren, doctors must be sure that her husband’s biological seed material is in perfect order.

The feature of spermogram for IVF is that it is necessary to take an analysis more than once. Sperm is a biological material that is very susceptible to any external and internal effects. In order to add up a more or less objective idea of ​​the fertility of a man, the analysis before IVF is repeated 2-3 times within two weeks. At this time, the woman is undergoing preparatory hormone treatment aimed at stimulating the ovaries.

Even if a man is 100% sure of his health, they won't believe him for a word - the risks are too great. Hormone therapy to which a woman is exposed cannot but affect her health, so it will be better for everyone if fertilization and implantation of the embryo takes place as soon as possible. For IVF success, both the quality of oocytes and the quality of spermatozoa are equally important.

It is important to take all the sperm before the upcoming procedure of in vitro fertilization in the same clinic, in the same laboratory. The fact is that different laboratories give different assessments due to differences in equipment, as well as the approach to standardization. The concept of norms in different clinics may also vary.

Preparation for spermogram is required. 3-5 days before putting you should abstain from sex and masturbation. A few days is enough to mature new cells. However, a longer abstinence makes the sperm more dense, and the results of the analysis may be outside the norm. A man a few weeks before delivery of ejaculate should avoid overheating, especially the scrotum. Within two weeks, alcohol should be severely restricted, and it is advisable to stop smoking.Taking antibiotics, hormonal drugs during the period of preparation for IVF is permissible only if fertilization is planned with frozen sperm or donor sperm and the biological material is already tested and ready for use.

Sperm for analysis is passed by masturbation in the clinic or at home with the collection of material in a sterile container. However, delivery in a clinical setting is considered more efficient, since there is no need to worry about the shelf life of the ejaculate. Seed should be delivered to the laboratory within 40–60 minutes. If the material is collected in the clinic, the question of urgent delivery is removed from the agenda.

The ejaculate in preparation for IVF is evaluated according to a number of indicators recommended by the World Health Organization (WHO). Let's look at each of them.

Normally, it is desirable that it correspond to the volume of a tablespoon. Speaking the dry language of medical numbers, the volume should be equal to 1.5-2 ml.

Sperm after ejaculation gradually becomes more liquid. Estimated time span that this process takes. Normally, semen becomes liquid in 15–55 minutes.

This is a very important parameter when preparing for IVF. If the acidity is below normal, the sperm cells practically lose their ability to dissolve the shell of the egg and penetrate inside. Since IVF, this process takes place, though not in the maternal organism, but nevertheless, they pay special attention to the level of acidity independently. Normally, it is 7.2–7.7.

High-precision laboratory equipment counts the number of spermatozoa in the total volume of ejaculate and in 1 milliliter of seminal fluid. Normally, cells should be at least 15–20 million in 1 milliliter and at least 40 million in total.

Not all sperm are motile, and this is perfectly normal. The laboratory assistants in the ejaculate, submitted for analysis, will allocate 4 groups of cells depending on their ability to move.

• sperm of species A - the most active and mobile, they always move straight and fast;
• cells of type B - also move straight, but a little slower;
• sperm of species C in general, they are able to move, but their movement is not straight: they are spinning in place, they can go not forward, but in the opposite direction;
• cell D motionless.

For successful IVF, it is important to assess not so much the quantity, but the quality of the male sex cells. Under a microscope, sperm cells are compared with an existing standard and discarded mutated cells. The structure of the head, its size, structure, shape, number and structure of the sperm tail, as well as the structure of the sperm neck are assessed. Only standard-compliant cells are considered morphologically healthy.

Normally, the proportion of healthy sperm with unchanged "appearance" should be at least 14-15%.

All motile sperm are live. But not all stills are dead. That is why the number of living cells is calculated separately. It is considered normal to have at least 50–58% of living cells in the ejaculate.

Leukocytes in semen are present in the vast majority of men. Normally, their number does not exceed 1 million per 1 milliliter.

When IVF, they have almost no value, but normally their number according to the relevant special tests should not exceed 50%.

It must be said that the modern level of development of reproductive auxiliary techniques will often allow to do the almost impossible - most forms of male infertility are not an obstacle to the IVF procedure.Even in a completely immobile sperm cell, there is its DNA set, which is necessary for the introduction into the egg cell. True, the procedure in this case will be called ICSI.

If a man has pathologically few spermatozoa, including live and mobile ones, in preparation for IVF, it is possible in the laboratory to select several perfectly healthy cells with microscopic methods. This will be enough to fertilize the egg, because in the end only a single sperm from tens of millions of cells that enter the body of a woman during natural conception penetrates the oocyte membrane.

With altered germ cell morphology, if the number of mutant cells is high, it is necessary to carry out DNA fragmentation analysis to find out if everything is in order with the genetic material. Then select several reference cells, which can be used for IVF or ICSI.

Only if the man has no live and suitable sperm at all, or does not produce them at all, or the man is a carrier of a dangerous genetic disease, does IVF with the donor's biomaterial be recommended to the woman. Usually use frozen material that is tested, researched and safe. The shelf life of cryopreserved sperm is 3 years. The validity of the thawed material is about an hour.

Improving the quality of sperm before passing the biomaterial to be used in the IVF protocol is desirable and possible. Even if the deviations in the spermogram are minor, simple and clear recommendations will help the man to improve fertility and his own well-being. If tests show the presence of infections, prior treatment is necessary.

After cleansing the male body from ureaplasma, chlamydia, after curing diseases of the prostate and other ailments, the quality of seminal fluid will be higher, and the quantity will increase.

If nothing is required, recommendations for improvement are almost always standard and traditional. For a start, a man needs to give up his bad habits: smoking and alcohol. Proper nutrition will also be useful: a man should not overeat, but his diet should be saturated with foods containing animal proteins (meat, milk, fish).

Correction may require the work schedule of the representative of the stronger sex. To normalize spermatogenesis, a man must sleep at night for at least 8 hours, and therefore work on the night shift is contraindicated. Bath and sauna lovers are advised to temporarily give up their habits, since any overheating of the scrotum leads to a decrease in the number of motile and active sperm. Underwear and pants should be fairly free, do not hold down and do not violate the blood supply to the genital and pelvic organs.

A doctor who plans an IVF protocol will tell you which vitamins and minerals can be taken by both women and men. The representatives of the stronger sex before the delivery of the biomaterial in approximately 2-3 months are prescribed such drugs as Speman, SpermActive, Spermaplant, Vitaprost, Speroton, Viardo, Spermastrong.

Among folk remedies, decoction of root devyasila, dogrose decoction, tea with sage, and juice from raw pumpkin pulp are especially popular. A man will benefit nuts, figs and honey. To bee products should be looked at especially: a pronounced effect on the composition of sperm have royal jelly and perga. The main thing that a man does not have an allergy to these products.

A moderately active lifestyle, lack of contact with harmful substances (nitrates, varnishes and paints, salts of heavy metals) during the period of preparation for IVF will help a man to significantly improve the quality of seminal fluid.

Do not underestimate the properties and characteristics of sperm. Very often, the IVF protocol fails only because the sperm cells are weak or their DNA set has been damaged.. With an average IVF of 20% with a bad spermogram, the success rate decreases to 5%. In this case, the pair is recommended to take a pause and try to improve the quality of the germ cells of her husband.

If this fails, despite strict adherence to all recommendations of the doctor, fertilization can be carried out using ICSI or IMSI. With them, a specific sperm cell is injected directly under the shell of the egg, whereas during IVF the eggs are in the same incubator with spermatozoa and sperm penetrate the oocyte almost spontaneously.

For information on how to take semen, see the following video.