With a basic semen analysis, we obtain a large amount of information. The general semen analysis has to be carried out in an appropriate manner. Before the analysis, the patient has to keep sexual abstinence for the period of 2 to 7 days. The optimum abstinence for the proper analysis is 2 to 3 days. If the semen analysis is performed after a longer abstinence period, it is likely that semen parameters will be a bit worse. If the semen analysis is performed after a period shorter than two days, we can obtain less sperm than in the case of observing the recommended abstinence period. The general semen analysis consists of several elements; first, the physicochemical parameters are assessed, that is the semen consistency and appearance, its liquefaction and volume. The proper volume of ejaculate ranges from 2 to 7 mL. A higher volume of ejaculate may indicate inflammation. Ejaculate volume below 2 mL is probably related to the lower contractility of seminal vesicles. Usually, it is associated with weaker arousal. The next assessed parameter is color. Semen should be milky-white, opalescent; if its color is translucent, this probably indicates the absence of sperm in the semen. Therefore, a macroscopic examination can tell us whether the male partner’s semen is more or less normal. In the general semen analysis, semen’s smell is also assessed. The semen’s smell is specific. The semen’s pH is slightly alkaline, so it neutralizes the acidic environment of the vagina and thus allows the sperm moving from the semen to the cervical mucus. Other semen parameters are examined microscopically. In the first place, we assess the number of sperm cells. A normal number of sperm is above 15 million per milliliter or above 32 million sperm in the whole ejaculate. Next we assess the sperm motility – we divide it into four types, from A to D. The sperm cells which have the ability to reach an egg cell naturally swim with the type A movement. When we want to use such semen for insemination, we consider that the valuable sperm, i.e. the sperm which have the chances for achieving their aim, are sperm cells swimming with the type A and B movement.
In vitro fertilization is possible with the use of any sperm with any type of movement, because sperm is introduced directly to an egg cell, so their motility is irrelevant. Another important parameter is sperm vitality. We can also carry out additional important tests, like sperm DNA fragmentation or sperm hyaluronic acid binding.