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HelpTest Code SOFT: Z1000 Strict Criteria Sperm Morphology for Infertility Diagnosis and Treatment, Semen
Additional Codes
| Ordering Mnemonic | Mayo Test ID |
|---|---|
| HOM: MISC LAB | MSTC |
Reporting Name
Strict Criteria Sperm MorphologyUseful For
Diagnosing male infertility
Selecting the most cost-effective therapy for treating male-factor infertility
Quantifying the number of germinal and white blood cells per mL of semen
Method Name
Kruger Criteria Strict Morphology
Performing Laboratory
Mayo Clinic Laboratories in Rochester
Specimen Type
SemenOrdering Guidance
Additional Testing Requirements
Conventional semen analysis, FER / Semen Analysis, Semen. should be performed in conjunction with this test.
Shipping Instructions
Semen specimen must arrive within 24 hours of collection. Send specimen Monday through Thursday only and not the day before a holiday. If holiday falls on a Saturday, holiday will be observed on the preceding Friday. Sunday holidays are observed on the following Monday. Specimen should be collected and packaged as close to shipping time as possible. Laboratory does not perform testing on weekends.
Necessary Information
Specimen volume is required.
Specimen Required
Container/Tube: Semen Analysis Kit (T178)
Collection Instructions: Patient should have 2 to 7 days of sexual abstinence at the time of semen collection for accurate results.
Specimen Volume: Total ejaculate
Specimen Minimum Volume
A minimum count 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.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)
Day(s) Performed
Monday through Friday
CPT Code Information
89398
LOINC Code Information
| Test ID | Test Order Name | Order LOINC Value |
|---|---|---|
| MSTC | Strict Criteria Sperm Morphology | 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 |
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.Clinical Information
Infertility affects 1 out of 6 couples of child-bearing age. Approximately 40% of infertility has a female-factor cause and 40% 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/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 also 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.
Interpretation
Categorizing sperm according to strict criteria based on measurements of head and tail sizes and shapes. Sperm with abnormalities in head/tail size/shape may not be capable of completing critical steps in sperm transport and fertilization.
Clinical Reference
1. Kruger Morphology Conference, Boston, MA, October 9, 1993
2. Cooper TG, Aitken J, Auger J, et al, eds. WHO laboratory manual for the examination and processing of human semen. 5th ed. WHO Press; 2010
3. Bjorndahl L, Apolikhin O, Baldi E, et al, eds: 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/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 WBCs are indicative of possible disorders in spermatogenesis and genital tract infection, respectively.(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, Baltimore, MD, 1991; Scoring is based on a modified method of WHO laboratory manual for the examination of human semen and sperm-cervical mucus interaction. 5th ed. Cambridge University Press; 2010)