Conduct to follow when confronted with abnormalities in the spermiogram

This article discusses the interest of spermiogram in the detection of male infertility as well as the conduct to follow when confronted with physical and quantitative abnormalities of sperm in men. In effect spermiogram is among the first-line analytical examinations conducted when working with an infertile couple. In the man it is the adequate measure of the reproduction of spermatozoa and maturation in the epididymis. Abnormalities detected by spermiogram are: abnormalities in viscosity volume color and pH. Regarding quantitative abnormalities these are abnormalities of number motility and morphology. Azoospermia means an abnormality either in the production of spermatozoa or in their transport. In the etiological approach the assay of plasma FSH is the key examination since it allows differentiation of the three different etiological entities specifically: azoospermia with diminished FSH which demonstrates insufficient hormonal stimulation of the testes; azoospermia with normal FSH which indicates an obstruction in sperm pathways of the epididymis the vas deferens or the ejaculatory ducts; and azoospermia with elevated FSH grouping all conditions that affect the testicular parenchyma and generally accompanied by testicular atrophy. Oligoasthenoteratospermia is the biological abnormality that is most often encountered in the infertility work-up it corresponds to a set of etiologies some of which are curable specifically an infection which requires a sperm culture and serologies for Chlamydia and mycoplasmas varicocele testicular insufficiency which is explained by a decrease in the number of spermatozoa with decreased motility and morphology and finally toxic and drug-related causes. This article presents also in the form of tables the anamnesis of a patient who was seen for an infertility work-up the drugs which have a negative effect on male fertility the normal values of the spermiogram and the conduct to follow when confronted with oligoasthenoteratospermia.