The diagnosis of Normozoospermia refers to semen that meets the parameters defined by the WHO in the seminogram.
The seminogram is a basic test that is classically performed on male sperm, and consists of obtaining a sample of it that is observed under the microscope, performing a count of the total, motile (progressive, slow and fast) sperm and an assessment of the shapes of sperm.
As we can see, it is an observer-dependent test, variable (since man does not always have the same amount of sperm or mobility at all times of his life) and is really old and not very technological.
To date, given that fertility research has focused primarily on the study of the female factor, as this is the one that has made the knowledge, technique and technology in reproductive medicine grow the fastest, we have few tools in the deeper assessment of male factor.
However, in recent years, male factor research has made great strides, such as:
- Sperm DNA fragmentation The action of external notes or packaging defects of the DNA transported by the sperm can generate problems at this level, which will translate into fertilizing an oocyte, they generate poor quality embryos or implantation failures.
- Sperm apoptosis Some spermatozoa not suitable for fertilization normally enter programmed cell death, apoptosis also called programmed cell suicide. These cells, which, because they are known to be unsuitable to generate a good embryo, have decided to die, are indistinguishable from normal cells and can therefore be used without the biologist noticing in assisted reproduction techniques, generating poor results.
- Alteration of sperm DNA protamination Protamines are proteins involved in the packaging of sperm DNA, necessary so that it is not altered on the long journey to the oocyte and the penetration process of the same. An alteration of this level will generate poor results in assisted reproductive techniques.
- FISH in sperm Although its use is somewhat controversial today, it is possible to detect the presence of an abnormal number of sperm carrying genetic alterations, which may be absolutely normal in shape, mobility, and the seminogram may present a normal count. These sperm will never produce the birth of a healthy baby.
Likewise, multiple cases of couples who have presented failures attributable to sperm are known in which the sperm values of all the tests performed were normal, but in which success was only achieved after therapy with sperm donation (these are cases rare in which all known tests and therapies have been pre-tested).
The alterations in all the parameters and tests mentioned could explain male fertility problems that could occur with a normal semen analysis.
In addition, research in the field of male infertility is increasing and it is expected that in the coming year’s new concepts and knowledge will be developed, as well as other tests that affect the study of semen, which has been little developed to date.