The spermiogram

One of the most important tests of male fertility is the spermiogram, the examination of the sperm cells.

Our spermiogram tests

For whom is the spermiogram "Basic" suitable?

  • first semen analysis
  • control spermiogram after abnormal findings

What is included in the spermiogram "Basic"n?

Your semen sample will be assessed according to the currently valid WHO 2021 criteria.

  • Total Motile Count (TMC): Total number of motile sperm cells in a sample
  • Number & concentration of sperm cells
  • Motility: forward moving (fast/slow), stationary or immobile
  • Appearance (morphology): normal or pathological forms
  • Macroscopic analysis: pH, appearance, viscosity, ...
  • Other parameters: White blood cells (leucocytes), precursors of sperm cells (germinal cells)

Where is it possible to deliver the sperm sample?

  • Delivery at the Kinderwunschzentrum: You can deliver the sample directly at the Kinderwunschzentrum an der Wien in our special sperm delivery rooms. As we have two rooms, you have enough time and can collect the sperm sample undisturbed and discreetly.
  • Delivery at home: The semen sample can also be delivered to your home. You will receive a semen cup from us in advance, which is labelled with your individual barcode (see Matching System). Important: The sample must be taken to our center within 60 minutes of delivery, warm from the body.

When is it possible to deliver the sperm sample?

  • Delivery at the Kinderwunschzentrum: Please make an appointment for the spermiogram "Basic". Appointments are possible Mon-Fri from 8:30 to 9 am and 1 to 2 pm. 
  • Delivery at home: Please let us know when you will bring the semen cup to us so that we can book a time slot in the IVF laboratory for analysis. You can drop off your cup Mon-Fri from 8:30 am to 2 pm in the Kinderwunschzentrum (level "Dachgeschoss 1").

What does the spermiogram "Basic" cost? 

The spermiogram "Basic" costs 136 euros.
You will receive your findings within 1 week - by e-mail or post, depending on your preference.

For whom is the spermiogram "Advanced" suitable?

  • pregnancy does not occur despite an inconspicuous spermiogram
    • suspicion that there are antibodies on the sperm cells
    • suspicion that fertilisation is not taking place because the sperm cells have not matured
  • interest in a detailed analysis of additional parameters that are relevant to the topic of conceiving

What is included in the spermiogram "Advanced"?

Your semen sample will be assessed according to the currently valid WHO 2021 criteria.

  • MAR test: determines whether there are antibodies on the sperm cells
  • HBA test: determines the maturity of the sperm cells by means of a hyaluronan binding test
  • Total Motile Count (TMC): Total number of motile sperm cells in a sample
  • Number & concentration of sperm cells
  • Motility: forward moving (fast/slow), stationary or immobile
  • Appearance (morphology): normal or pathological forms
  • Macroscopic analysis: pH, appearance, viscosity, ...
  • Other parameters: White blood cells (leucocytes), precursors of sperm cells (germinal cells)

Where is it possible to deliver the sperm sample?

 

  • Delivery at the Kinderwunschzentrum: You can deliver the sample directly at the Kinderwunschzentrum an der Wien in our special sperm delivery rooms. As we have two rooms, you have enough time and can collect the sperm sample undisturbed and discreetly.

  • Delivery at home: The semen sample can also be delivered to your home. You will receive a semen cup from us in advance, which is labelled with your individual barcode (see Matching System). Important: The sample must be taken to our center within 60 minutes of delivery, warm from the body.

When is it possible to deliver the sperm sample?

Please make an appointment for the "Advanced" spermiogram - the appointments for this spermiogram take place once a week.

What does the spermiogramm "Advanced" cost?

The spermiogramm "Advanced" costs 250 euros.
You will receive your findings within 1 week - by e-mail or post, depending on your preference.

For whom is the spermiogram "Expert" suitable?

  • pregnancy does not occur despite an inconspicuous spermiogram
  • poor fertilisation rates / embryo development during IVF treatment
  • repeated miscarriages in early pregnancy
  • control of previously diagnosed increased oxidative stress
  • Interest in comprehensive analysis of all parameters relevant to the topic of conceiving 

What is included in the spermiogram "Expert"?

Your semen sample will be assessed according to the currently valid WHO 2021 criteria.

  • SperMovie: you receive a personal video of your semen analysis for downloading
  • MiOXSYS®: measures the oxidative stress caused by free radicals in the ejaculate
  • DNA Fragmentation Index (DFI): percentage of sperm cells with conspicuous or destroyed genetic information
  • MAR test: determines whether there are antibodies on the sperm cells
  • HBA test: determines the maturity of the sperm cells by means of a hyaluronan binding test
  • Detailed discussion of the findings & possible therapy options with our team of doctors (optional)
  • Total Motile Count (TMC): Total number of motile sperm cells in a sample
  • Number & concentration of sperm cells
  • Motility: forward moving (fast/slow), stationary or immobile
  • Appearance (morphology): normal or pathological forms
  • Macroscopic analysis: pH, appearance, viscosity, ...
  • Other parameters: White blood cells (leucocytes), precursors of sperm cells (germinal cells)

Where is it possible to deliver the sperm sample?

With the spermiogram "Expert", delivery is only possible directly at the Kinderwunschzentrum an der Wien. For the determination of the MiOXSYS (oxidative stress) and the DNA fragmentation index, the semen sample is processed immediately after it has been collected and liquefied. Faulty transport, for example, could therefore falsify the sample. You can deliver the sample directly to our special semen delivery rooms. Since we have two rooms, you have enough time and can give the semen sample undisturbed and discreetly.

When is it possible to deliver the sperm sample?

Please make an appointment for the "Expert" spermiogram - the appointments for this spermiogram take place once a week.

What does the spermiogramm "Expert" cost?

The spermiogramm "Expert" costs 475 euros incl. the discussion of findings with our team of doctors*.
The spermiogramm "Expert" costs 425 euros with external discussion of findings with our urologist.
You will receive your findings within 1 week - by e-mail or post, depending on your preference.
*Please arrange this appointment directly at the spermiogram appointment or after receiving the results.

Choose a spermiogram "Basic" if...

  • ...this is your first spermiogram and you would like an inexpensive analysis.
  • ...you would like a check after an abnormal result.
  • Costs: € 136.-

Choose a spermiogram "Advanced" if...

  • ...you are interested in a detailed analysis of additional parameters that are relevant to the topic of conceiving.
  • ...your sperm test results have been unremarkable so far, but still no pregnancy has occurred.
  • ...there is a suspicion that there are antibodies on the sperm cells.
  • ...there is a suspicion that fertilisation is not taking place because the sperm cells have not matured.
  • Costs: € 250.-

Choose a spermiogram "Expert" if...

  • ...you are interested in a comprehensive analysis of all parameters that are relevant to the topic of conceiving.
  • ...you would like to discuss the results of the spermiogram with our team of experts and receive recommendations.
  • ...you would like to receive your personal SperMovie - a microscope video of your sperm cells during the analysis.
  • ...your sperm test results have been unremarkable so far, but still no pregnancy has occurred.
  • ...you had poor fertilisation rates / embryo development during IVF treatment.
  • ...you have had repeated miscarriages in early pregnancy with your current or former partner.
  • Costs: € 475.- incl. discussion of findings, € 425.- excl. discussion of findings

How can I improve my sperm quality?

Are you fit for the Fertility Journey?
With SpermBoost you improve the number and quality of your sperm cells!

Research results show that the majority of couples - approximately 2/3 - can't achieve pregnancy due to reduced sperm quality. We have researched numerous studies specifically for men with abnormal spermiogram results, which have examined the optimisation of the number and quality of sperm cells through nutritional supplements. Based on these findings, we have put together a package of suitable preparations for you in cooperation with the experts at Saint Charles Pharmacy. 


The following active substances have been shown to be effective in a recent study:

  • Ubiquinol/CoEnzyme Q10: can have a positive effect on the concentration and motility of sperm cells.
  • L-Arginine: is said to increase both the quantity and the (progressive) motility of the sperm.
  • N-acetyl cysteine (NAC): can improve the volume, motility and viscosity of the ejaculate. It is also said to make the seminal fluid more resistant to oxidative stress caused by free radicals.
  • Inositol: is thought to regulate male hormone balance and promote a higher proportion of normally developed sperm cells. It can also improve sperm count and motility.


All supplements are in stock for you at our partner pharmacy, the Saint Charles Pharmacy. The experts on site will be happy to advise you!

Important: Remember that you must take SpermBoost for at least 90 days to see possible results. This is because the body needs that long to form and mature new sperm cells (=spermatogenesis).

Receiving an abnormal spermiogram result can overwhelm many men and cause a feeling of helplessness. We would like to reassure you with our recommendations on therapy, nutritional supplements and lifestyle and show you what you can do yourself to improve your sperm quality. In addition, optimising your lifestyle can increase the chances of pregnancy or a possible successful treatment.
Below you will find our lifestyle tips for your fertility and the topic of achieving pregnancy.

 

Healthy nutrition & weight

  • Eat 60g of walnuts daily - Studies have proven that they significantly improve sperm quality! 
  • Make sure you drink enough fluids and eat more vegetables, whole grains and healthy fats.
  • Reduce your daily caffeine intake to about 2 cups of coffee or 1 caffeinated drink (energy drinks, cola).
  • We recommend the intake of vitamins and micronutrients (SpermBoost).
  • If you are overweight, we recommend losing weight to significantly improve the quality of the sperm cells. 

Smoking & Alcohol / drugs

  • Our recommendation can only be: Stop smoking - the sooner the better!
  • Smoking reduces the semen quality in all parameters by about 20% and damages the genetic information.
  • We recommend a maximum of 1-3 alcoholic drinks per week, as alcohol also has a negative influence on fertility.
  • Drug consumption is a "no-go" for fertility and the desire to have children and affects the quality of semen.

Sports & movement

  • Integrate exercise into your daily routine (climbing stairs, walking or cycling more) and do sports with moderate exertion.
  • Spinning/cycling: We advise you against hours of intense exercise, as heat, friction and tightness have been shown to damage sperm cells.
  • Other sporting activities such as extreme weight training are also not recommended. Taking performance-enhancing substances (anabolic steroids, steroids) can significantly reduce sperm quality and is strongly discouraged if you wish to have children. 

Stress, Psyche & Sleep

  • Chronic stress can have a negative effect on semen quality - so try to integrate various "moments of relaxation" into your everyday life - be it meditation, yoga or a walk in nature. Our psychotherapist Mag. Eveline Leitl will also be happy to support you.
  • Make sure you get enough sleep between 7-8 hours - if the regeneration phase is too short (less than 6 hours) or too long (more than 9 hours), fertility can decrease. 

What does my spermiogram result mean?

Concentration

The concentration indicates the number of sperm cells in 1ml of ejaculate.

Reference values according to WHO 2021:

Motility

Motility indicates whether and how many motile sperm cells are present.

Reference values according to WHO 2021:

Morphology

Morphology indicates how many sperm cells are normal or pathologically shaped.

Reference values according to WHO 2021:

Aspermia is the absence of ejaculation despite orgasm. One reason for this can be retrograde ejaculation, in which the seminal fluid is ejaculated backwards into the urinary bladder instead of through the penis.

 

Our recommendations:

  • Therapy recommendation:
    • Counselling & therapy by your urologist
    • If retrograde ejaculation is present: Several days of medication to prepare for sperm collection (urine becomes alkaline). Then semen collection by means of masturbation and urine collection. Artificial insemination by means of ICSI is then possible.

Asthenozoospermia is diagnosed when there is reduced motility (<30%) of the sperm cells in the ejaculate.

 

Our recommendations:

  • Therapy recommendations:
    • In-vitro fertilization using the ICSI method
  • SpermBoost: Optimizing your sperm quality with nutritional supplements
  • Lifestyle tips: Optimizing your lifestyle (find our recommendations here)

We speak of asthenoteratoozoospermia when the motility (<30%) of the sperm cells is reduced and the appearance (<4%) is conspicuous.  

 

Our recommendations:

  • Therapy recommendation:
    • In-vitro fertilization using the ICSI method
    • various additional methods in consultation with our team of experts
  • SpermBoost: Optimizing your sperm quality with nutritional supplements
  • Lifestyle tips: Optimizing your lifestyle (find our recommendations here)

In azoospermia, no sperm cells can be found in the ejaculate.

 

Our recommendations:

The determination of the so-called "DNA Fragmentation Index (DFI)" is a further analysis that provides information about the percentage of sperm cells that have conspicuous genetic information. One of the main causes of DNA damage in sperm cells is an imbalance of free oxygen radicals (ROS) and protective substances (antioxidants) in the ejaculate. This imbalance leads to so-called "oxidative stress", which attacks the cell structure and leads to DNA damage.

 

Interpretations:

  • DFI < 15%: DNA fragments could be detected in < 15% of the sperm cells. The DNA integrity is not affected and shows a normal result.
  • DFI 15-30%: DNA fragments could be detected in 15-30% of the sperm cells. The DNA integrity shows borderline impairment.
  • DFI > 30%: DNA fragments could be detected in > 30% of the sperm cells. Sperm DNA integrity is severely impaired. According to current scientific findings, in-vitro fertilization using the ICSI method is recommended.

 

Our recommendations:

  • Therapy recommendation with a DFI 15-30%:
    • Control spermiogram after 90 days (useful and recommended after taking SpermBoost and lifestyle optimisation)
    • Therapy planning with a fertility expert
  • Therapy recommendation with a DFI > 30%:
    • Control spermiogram after 90 days (useful and recommended after taking SpermBoost and lifestyle optimisation)
    • in-vitro fertilization using the ICSI method
  • SpermBoost: Optimizing your sperm quality with nutritional supplements
  • Lifestyle tips: Optimizing your lifestyle (find our recommendations here)

Globozoospermia is characterised by round, spherical sperm heads caused by the absence of the acrosome (part of the head). It is a rare form of male infertility.

 

Our recommendations:

The HBA test determines the maturity of the sperm cells using a hyaluronan binding test. This test is thus an indirect proof of whether the sperm cells are able to dock to the egg membrane of the egg cell and thus fertilize the egg cell. A lack of binding to hyaluronan additionally indicates a high percentage of sperm cells that are not normally formed. A normal result is present with a hyaluronan binding of ≥ 80%.

 

Our recommendations:

  • Therapy recommendation:
    • In-vitro fertilization using the ICSI method

Hypospermia is diagnosed when the amount of ejaculate is < 1.4 ml.

 

Our recommendations:

  • Therapy recommendation:
    • Counselling & therapy with your urologist
    • observe a longer period of abstinence for the next spermiogram

The Kremer test checks whether sperm cells can enter the cervical mucus and survive there. Antibodies can be present in the cervical mucus which are directed against the sperm cells and make them immotile. This can be an obstacle for the sperm cells on their way to the egg cell.

To find out whether there are antibodies against sperm cells in the cervical mucus, a sample of the cervical mucus is taken from the cervix with a pipette. At the same time, a sperm sample from the partner is needed; this sample can either be obtained directly at the Kinderwunschzentrum an der Wien or alternatively brought from home within 60 minutes, warm from the body. In the laboratory it is then checked whether the sperm cells are able to migrate unhindered into the mucus and move around there. If sperm cells become immotile in the cervical mucus, it can be concluded that antibodies are present.

An abnormal test result can - if there are no other reasons - be a cause for the absence of a pregnancy.

 

Interpretations:

  • negative: No conspicuous interaction between the cervical mucus and the sperm cells could be detected.
  • positive grade 1(+): The test result indicates a low antibody titre in the cervical mucus. This means that the motility of the sperm cells in the cervical mucus is slightly restricted and thus the probability of fertilization is limited.
  • positive grade 2(++): The test result indicates a moderate antibody titre in the cervical mucus. This limits the motility of the sperm cells in the cervical mucus and thus reduces the probability of fertilization.
  • positive grade 3(+++): The test result indicates a high antibody titre in the cervical mucus. As a result, the motility of the sperm cells in the cervical mucus is severely restricted and thus the probability of fertilization is significantly reduced.

      Note: In some cases, it is not possible to perform the Kremer test for the reasons listed below. Nevertheless, a spermiogram "Basic" will be performed and an analysis of the cervical mucus will be carried out.

      • Sperm cells present in the mucus: There are already sperm cells in the cervical mucus at the time of collection, so further assessment of the Kremer test would not be meaningful. Nevertheless, sperm cells in the mucus indicate an inconspicuous interaction. The Kremer test is therefore unremarkable in the sense of a post-coital test.
      • Acidic pH value of the mucus: Sperm cells are immotile in an acidic environment and further assessment of the Kremer test would not be meaningful.
      • Amount of mucus insufficient for analysis

      • Contamination of the mucus: Massive contamination by cellular elements (e.g. leukocytes, epithelial cells, erythrocytes) makes assessment of the Kremer test impossible.

      • Reduced semen quality: In the case of a low concentration or restricted motility of the sperm cells (e.g. asthenozoospermia, oligozoospermia, oligoasthenozoospermia), the assessment of the Kremer test is not meaningful.

       

      Our recommendations:

      • Therapy recommendation:
        • Insemination* in case of abnormal test result
        • In-vitro fertilization (IVF/ICSI)* in case of abnormal test result

      *Therapy planning takes place together with our fertility experts depending on all the couple's findings.

      Cryptozoospermia is diagnosed when no sperm cells can initially be detected in the ejaculate, but sperm cells are later found after centrifugation in the laboratory.

       

      Our recommendations:

      Leukospermia: If an increased number of white blood cells (≥ 1 million / ml leukocytes) can be detected in the ejaculate, this is called leukospermia. This may indicate an infection. If you have upright health insurance in Austria, we will order a bacteriological examination in this case.

      Haematospermia: If red blood cells (erythrocytes) are detectable in the ejaculate, this is called haematospermia. This can have many causes, such as urinary tract infections or trauma.

       

      Our recommendations:

      • Therapy recommendation:
        • Counselling & therapy by your urologist
        • Control spermiogram after 4-6 weeks
        • In-vitro fertilization using the ICSI method (in case of leukospermia)

      The MAR test detects certain antibodies on the sperm cells that cause sperm cells to adhere to each other. As a result, the individual sperm cells are restricted in their freedom of movement and are thus no longer able to move forward optimally and thus fertilize the egg cell. The MAR test is conspicuous in > 50% of the antibodies detected in the ejaculate.

       

      Our recommendations:

      • Therapy recommendation:
        • Insemination (if the antibodies can be removed during sperm preparation)
        • In-vitro fertilization using the ICSI method (if the antibodies cannot be removed during sperm preparation)

      Necrozoospermia is diagnosed when only immotile sperm cells can be detected in the ejaculate.

       

      Our recommendations:

      • Therapy recommendation:
        • Sperm donation
        • Causal clarification by urologist and/or genetic counselling with OÄ Dr. Katharina Rötzer
        • depending on the cause: testicular biopsy (TESE) - extraction of the sperm cells through a testicular biopsy and subsequent in-vitro fertilzation using the ICSI method

      In normozoospermia, there are no abnormalities in the spermiogram findings. Normozoospermia is diagnosed when both the concentration per ml and the total number as well as the percentage of motile and normally formed sperm cells are equal to or above the respective reference range (according to WHO 2021).

       

      Our recommendations:

      • Therapy recommendation:
        • Many treatment options are possible with normozoospermia. However, it is important to plan the treatment in detail with our team of doctors, taking into account all the findings of your partner.
        • If you have been trying to achieve pregnancy for a long time - despite normozoospermia - we recommend a more detailed sperm analysis (see spermiogram "Advanced" / "Expert").

      Oligozoospermia is diagnosed when the concentration of sperm cells is < 16 million / ml or the total number of sperm cells is < 39 million.

       

      Our recommendations:

      Oligoasthenozoospermia is diagnosed when the concentration of sperm cells is < 16 million / ml or the total number of sperm cells is < 39 million / ml. In addition, there is reduced motility (<30%) of the sperm cells in the ejaculate.

       

      Our recommendations:

      Oligoteratozoospermia is diagnosed when the concentration of sperm cells is < 16 million / ml or the total number of sperm cells is < 39 million / ml. In addition, a restriction of the appearance (<4% normal forms) of the sperm cells in the ejaculate is present.

       

      Our recommendations:

      • Therapy recommendation:
        • In-vitro fertilization using the ICSI method
        • Genetic counselling with OÄ Dr. Katharina Rötzer (concentration of sperm cells < 1 million / ml)
        • various additional methods in consultation with our team of experts
      • SpermBoost: Optimizing your sperm quality with nutritional supplements
      • Lifestyle tips: Optimizing your lifestyle (find our recommendations here)

      Oligoasthenoteratozoospermia is diagnosed when the concentration of sperm cells is < 16 million / ml or the total number of sperm cells is < 39 million / ml. In addition, there is a reduced motility (<30%) as well as a restriction of the appearance (<4% normal forms) of the sperm cells in the ejaculate.

       

      Our recommendations:

      • Therapy recommendation:
        • In-vitro fertilization using the ICSI method
        • Genetic counselling with OÄ Dr. Katharina Rötzer (concentration of sperm cells < 1 million / ml)
        • various additional methods in consultation with our team of experts
      • SpermBoost: Optimizing your sperm quality with nutritional supplements
      • Lifestyle tips: Optimizing your lifestyle (find our recommendations here)

      Oxidative stress is the result of an imbalance of free oxygen radicals (ROS) and protective substances (antioxidants). Free oxygen radicals are created by environmental influences and negative lifestyle factors (e.g. smoking, unhealthy diet). In addition, the amount of free oxygen radicals is age-dependent and increases significantly from the age of 30. Oxidative stress attacks the cell structure of the sperm cells and damages the DNA.

      MiOXSYS® is a test that accurately measures oxidative stress and gives the static oxidation reduction potential (sORP). This value describes the balance between the total content of oxidants and antioxidants in a seed sample. A conspicuous result is present with a standardised sORP ≥ 1.38 mV/Mio sperm cells per millilitre.

       

      Our recommendations:

      • SpermBoost: Optimizing your sperm quality with nutritional supplements
      • Lifestyle tips: Optimizing your lifestyle (find our recommendations here)
      • MiOXSYS® control test: after at least 90 days (after successful SpermBoost intake and lifestyle optimization), costs: € 99.-

      If the pH value is < 7.2, the ejaculate is said to have an acidic pH value. This can have a negative effect on semen quality (motility).

       

      Our recommendations:

      • Therapy recommendation:
        • Counselling & therapy by your urologist/urologist

      Retrograde ejaculation is divided into two forms:

      • Total form: Aspermia - no seminal fluid is transported into the penis
      • Partial form: part of the seminal fluid is transported into the penis, the other part into the urinary bladder

       

      Our recommendations:

      • Therapy recommendation:
        • Depending on the findings, in-vitro fertilization using the ICSI method or a testicular biopsy (TESE) is possible
        • Alkalisation of the urine has not taken place: Control spermiogram after successful alkalisation
        • Counselling & therapy by your urologist/urologist

      Teratozoospermia is diagnosed when there is a restriction in the appearance (<4% normal forms) of the sperm cells in the ejaculate.

       

      Our recommendations:

      • Therapy recommendation:
        • In-vitro fertilization using the ICSI method
        • various additional methods in consultation with our team of experts
      • SpermBoost: Optimizing your sperm quality with nutritional supplements
      • Lifestyle tips: Optimizing your lifestyle (find our recommendations here)

      One of the best indicators of male fertility is the "Total Motile Count" (TMC). The TMC calculates the total number of motile sperm in a sample and thus gives an estimate of how much time is needed on average for a spontaneous pregnancy to occur. In addition, the TMC helps you plan fertility treatment - depending on your partner's findings, of course. The TMC is calculated by multiplying the concentration of sperm by the total volume of the sample and the percentage of forward motility.

      Total Motile Count (TMC):  Concentration/ml x total volume in ml x % progressively moving sperm cells

       

      Results:

      • ≥ 20: natural conception is possible
      • 9-20: insemination is recommended
      • < 8: in-vitro fertilization (IVF/ICSI) recommended

      A vitality test determines the percentage of living and therefore vital sperm cells. A restriction of vitality exists at < 54% of living sperm cells.

       

      Our recommendations:

      • Therapy recommendation:
        • In-vitro fertilization using the ICSI method
      • SpermBoost: Optimizing your sperm quality with nutritional supplements
      • Lifestyle tips: Optimizing your lifestyle (find our recommendations here)