Diagnosing male infertility
Selecting the most cost-effective therapy for treating male-factor infertility
Quantifying the number of germinal and WBCs per mL of semen
Kruger Criteria Strict Morphology
Fertility Testing
Infertility Testing
Semen Analysis
Sperm Analysis
Sperm Motility
Semen
Conventional semen analysis (FER / Semen Analysis, Semen) should be performed in conjunction with each strict criteria sperm morphology.
Send specimen Monday through Friday
Sperm count/mL is required (million/mL).
Question ID | Description | Answers |
---|---|---|
OSSC1 | Sperm Count/mL(x10(6), XX.X) |
Patient Preparation: Patient should have 2 to 7 days of sexual abstinence at the time of semen collection for accurate results.
Container/Tube: Slides
Specimen Volume: 2 slides-10 microL of liquefied semen on each slide
Collection Instructions:
1. If sperm concentration is <10 million/mL, centrifuge the specimen at 300 x G for 10 minutes before making slides.
2 Label 2 frosted slides in pencil with the patient's first and last name and the date of specimen collection. No adhesive labels.
3. Allow the semen to liquefy for 30 minutes.
4. Place 10 mcL of liquefied semen on the label end of each slide, and evenly smear the specimen using a plain slide (this process is the same as making a blood smear).
5. Allow the smears to air dry for 15 minutes before placing both slides into 1 slide holder for shipment.
A minimum count of sperm is needed; lab will determine
Specimen Type | Temperature | Time | Special Container |
---|---|---|---|
Semen | Ambient |
Diagnosing male infertility
Selecting the most cost-effective therapy for treating male-factor infertility
Quantifying the number of germinal and WBCs per mL of semen
Infertility affects 1 out of 6 couples of child-bearing age. Approximately 40% of infertility cases have a female-factor cause and 40% have a male-factor cause. The remaining 20% of infertility is due to a combination of male- and female-factor disorders or is unexplained.
Abnormalities in sperm morphology are related to defects in sperm transport, sperm capacitation, the acrosome reaction, binding and penetration of the zona pellucida, and fusion with the oocyte vitelline membrane. All of these steps are essential to normal fertility.
Strict criteria sperm morphology testing greatly assists with selecting the most cost-effective in vitro sperm processing and insemination treatment for the couple's in vitro fertilization (IVF) cycle. Sperm with severe head abnormalities are unlikely to bind to the zona pellucida. These patients may require intracytoplasmic sperm injection in association with their IVF cycle to ensure optimal levels of fertilization are achieved. This, in turn, provides the patient with the best chance of pregnancy.
Normal forms: > or =4.0%
Germinal cells/mL
<4 x 10(6) (normal)
> or =4 x 10(6) (elevated germinal cells in semen are of unknown clinical significance)
WBC/mL
<1 x 10(6) (normal)
> or =1 x 10(6) (elevated white blood cells in semen are of questionable clinical significance)
Categorizing sperm according to strict criteria based on measurements of head and tail sizes and shapes. Sperm with abnormalities in head, tail size, or shape may not be capable of completing critical steps in sperm transport and fertilization.
No significant cautionary statements.
1. Kruger Morphology Conference, Boston, MA, October 9, 1993
2. WHO laboratory manual for the examination and processing of human semen. 5th ed. WHO Press; 2010
3. WHO laboratory manual for the examination and processing of human semen. 6th ed. World Health Organization; 2021
Sperm is categorized according to strict criteria based on measurements of head and tail sizes and shapes. Sperm with abnormalities in head, tail size, or shape are not capable of completing steps in the sperm transport and fertilization process. Quantification of the germinal and white blood cell (WBC) content in semen is performed because the presence of germinal and WBC are indicative of possible disorders in spermatogenesis and genital tract infection, respectively. The information collected will help determine the most cost-effective therapy for treating male-factor infertility. (Wazzan W, Thomas A: Genital infection and male infertility. AFS Annual Meeting, Postgraduate course, 1990; Menkveld R, Oettle E, Kruger T, et al: Atlas of Human Sperm Morphology. Williams and Wilkins; 1991; Scoring is based on a modified method of WHO laboratory manual for the examination and processing of human semen. 6th ed. World Health Organization; 2021)
Monday through Friday
This test has been cleared, approved, or is exempt by the US Food and Drug Administration and is used per manufacturer's instructions. Performance characteristics were verified by Mayo Clinic in a manner consistent with CLIA requirements.
89398
Test Id | Test Order Name | Order LOINC Value |
---|---|---|
MSTC1 | Strict Sperm Morphology, Slide | 48812-2 |
Result Id | Test Result Name |
Result LOINC Value
Applies only to results expressed in units of measure originally reported by the performing laboratory. These values do not apply to results that are converted to other units of measure.
|
---|---|---|
OVAL2 | Strict Morph NL | 10622-9 |
ACRSM | Acrosom Defect | 66494-6 |
HDSAB | Head Shape Abnormal | 66495-3 |
HDZAB | Head Size Abnormal | 66496-1 |
MD | Midpiece Defect | 10603-9 |
TAILD | Tail Defect | 10604-7 |
DBLF | Double Forms | 66497-9 |
MULTI | Multiple Defects | 66498-7 |
GERM3 | Germ Cells/mL | 10576-7 |
WBC6 | WBC/mL | 10579-1 |
CMT56 | Comment | 48767-8 |