The main starting point for the diagnosis of male infertility, aside from questioning, examining, and investigating the patient, is sperm analysis, counting the number and determining the properties of spermatogenesis cells. It should be noted that for greater accuracy of the spermogram result, the analysis should be repeated 2-3 times. In this case, abstinence from sexual activity should be no less than 3 days and no more than 5 before each examination.

The volume of ejaculate is normally 3-5 ml (approximately one teaspoon).

A decrease in ejaculate volume may indicate reduced testicular and sex gland function. With a sperm volume of less than 2 ml, conception is unlikely, even if other spermogram indicators are unchanged. The number of sperm in 1 ml of semen can vary within very wide limits, but should be at least 20 million. A reduction in the number of sperm is called oligozoospermia. This can occur as a result of reduced testicular function or unilateral obstruction of the seminal ducts. With complete absence of testicular function or bilateral obstruction, azoospermia is observed - complete absence of spermatozoa in the ejaculate. Patients often ask surprised questions - if only one sperm is needed for fertilization, why does a reduction in their number in the spermogram, say, to 1 million make conception practically impossible? The best answer to this question is these numbers. During ejaculation, an average of about 200 million spermatozoa reach the cervix. Only half of them manage to overcome the mucous plug of the cervical canal. Of the remaining quantity, only a small part reaches the opening of the fallopian tubes, and, since the egg is located in only one fallopian tube, half of the sperm ends up being idle. Again, not all sperm manage to reach the fallopian tube itself. As a result of all this, only about 200 sperm reach the egg. The motility of sperm is an important characteristic of sperm quality. Normally, more than half of all sperm should move forward, or at worst chaotically. A reduction in the number of motile sperm is called asthenozoospermia, absence is called necrozoospermia. The number and motility of sperm in ejaculate largely depend on the frequency of a man's sexual activities. When sexual acts are performed consecutively, it is considered that starting from the third act, the man's sperm loses fertility. Frequent sexual activities lead to less mature forms of sperm appearing in the ejaculate. which have less mobility and viability. The morphology of sperm shows what percentage of them have a normal, full-fledged structure. More than half of all sperm must have a normal structure. A reduction in this indicator is called teratozoospermia and also decreases the likelihood of conception. Agglutination, or the sticking of sperm to each other, and aggregation of sperm is normally absent. Their presence significantly reduces the mobility of the sperm and the likelihood of conception. This may be due to the dysfunction of the gonads, which can develop against the background of chronic prostatitis and vesiculitis, as well as due to irregular sexual life, inflammatory diseases, etc. The number of leukocytes in the ejaculate should not exceed 1-2 in the field of view. A significant number of leukocytes may indicate an acute inflammatory process of the urogenital tract - orchitis, epididymitis, prostatitis, vesiculitis, urethritis, etc. In this case, the doctor must conduct a thorough examination of the patient. Most spermogram indicators are very labile, meaning they can change for many reasons. These include the season of the year, the quality of nutrition, the presence of stress, overheating of the body, exposure to harmful chemical and physical environmental factors. Modern ICSI techniques allow for achieving pregnancy using individual spermatozoa or even spermatogenesis cells.