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Test Code MSTC1 Strict Criteria Sperm Morphology for Infertility Diagnosis and Treatment, Semen

Useful For

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

Reporting Name

Strict Sperm Morphology, Slide

Specimen Type

Semen


Ordering Guidance


 



Additional Testing Requirements


Conventional semen analysis (FER / Semen Analysis, Semen) should be performed in conjunction with each strict criteria sperm morphology.



Shipping Instructions


Send specimen Monday through Friday



Necessary Information


Sperm count/mL is required (million/mL).



Specimen Required


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.


Specimen Minimum Volume

A minimum count of sperm is needed; lab will determine

Specimen Stability Information

Specimen Type Temperature Time Special Container
Semen Ambient

Reject Due To

All specimens will be evaluated at Mayo Clinic Laboratories for test suitability.

Clinical Information

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.

Reference Values

Normal forms: ≥4.0%

Germinal cells/mL

<4 x 10(6) (normal)

≥4 x 10(6) (elevated germinal cells in semen are of unknown clinical significance)

WBC/mL

<1 x 10(6) (normal)

≥1 x 10(6) (elevated white blood cells in semen are of questionable clinical significance)

Interpretation

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.

Cautions

No significant cautionary statements.

Clinical Reference

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

Method Description

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)

Day(s) Performed

Monday through Friday

Report Available

2 to 4 days

Performing Laboratory

Mayo Clinic Laboratories in Rochester

LOINC Code Information

Test ID Test Order Name Order LOINC Value
MSTC1 Strict Sperm Morphology, Slide 48812-2

 

Result ID Test Result Name Result LOINC Value
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

Specimen Retention Time

At least 6 months

Method Name

Kruger Criteria Strict Morphology

Test Classification

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.

CPT Code Information

89398

Secondary ID

35184