I plan to do a spermogram

[Investigator]

A search for "spermogram" on the forum gives surprisingly few occurrences, and so, if it hasn't been explored much, also gives hope that we may be able to find something. All in-vitro clinics offer spermograms.

What one can do is a "basic spermogram" that gives sperm counts and a few other basic things, and then add some extras, for extra fee. I was looking at what extras I can add. One is a test for IgG and IgA antibodies in sperm. That sounds super relevant for us. Another is a test for leukocytes in sperm - apparently, if this is elevated, it's a sign of a possible infection (bacterial or otherwise) or some problem somewhere in the reproductive tract. The pH is also important, if off limits, it can be a sign of a problem. There is also a "MAR test for anti-sperm antibodies". It's listed separately from the test for IgG and IgA antibodies in the price list, I wonder if anyone understands the difference.

I don't think the "morphology" of sperm is relevant for us - although, if it is included in the "basic" spermogram, I would be curious about it as well.

If you look at the website of any in vitro clinic, you will see these tests, they are pretty standard. Which one(s) do you think would be most relevant? I want to spend money wisely and doing relevant tests, rather than just checking every single tab. Also, yes, if I want to, I can do a consultation with an "andrologist" in one of these clinics, who would ideally guide me through what the different tests measure and prescribe the tests. However, if I explain him the POIS stuff, he'd most likely tell me not to do any test because it is all in my head. That's why, basically, I want to save money from the exam with the doctor and simply self-prescribe the specific extras to the basic spermogram. Better do one more test than the useless consultation. 

To put it simply, I've allowed myself now to spend some money on a spermogram+extras, and I am asking for proposals on which extras you'd advise me to include. The ones testing antibodies and leukocytes will be a must. 

If you read texts online about what men do to improve their spermograms, you will see a lot of supplements familiar to members of this forum.  While the primary goal of the spermogram is to identify causes of infertility and surely, POIS is something completely different (some members of this forum have kids), still, a spermogram can give us insights.

Just a reminder that the goal is for us to find something that is "off" in some way, consistently across POIS sufferers - then we (or researchers) would be able to apply for NIH grants for more money. That's the realistic goal of the NORD study as well, really.

[Muon]

Spermogram table 2, seems all normal. Translate the stuff for details:
Postorgasmic illness syndrome: випадок із практики

Interleukin 8 and the male genital tract

"Conclusions

There is increasing evidence that sIL-8 may represent the main pro-inflammatory chemokine related to MGT infection/inflammation. In particular, sIL-8 appears to be strongly related to inflammation of the prostate, while evidence for a correlation with seminal vesicles, and epididymis inflammation is emerging. We think that sIL-8 will have a progressive important clinical role, not only identifying subjects with and/or corroborating clinical/ultrasound findings suggestive of MGT infection/inflammation, but also helping to start a specific therapy and monitor the course of inflammatory diseases."

sIL-8 = Seminal Plasma Interleukin 8

[Investigator]

Interesting. In Table 2, about leukocytes, it says 8-12-15, what do you think is that? Under "norm", it says "single" - I think it should be translated as "a few." But note that this spermogram does not include antibodies, that is, the MAR test. I will definitely include the MAR test. It is very important because it could indicate a possible problem in the blood-semen barrier.  But the table teaches me that indeed, I don't want to spend money on "morphology."

About IL-8, I can't test it separately, I checked with those labs. If it is included in the "basic spermatogram", that would be great, or else, maybe it will affect something else that is included.

[Muon]

Interesting. In Table 2, about leukocytes, it says 8-12-15, what do you think is that?

I have no idea, just wanted to inform you about the table.

About IL-8, I can't test it separately, I checked with those labs. If it is included in the "basic spermatogram", that would be great, or else, maybe it will affect something else that is included.

Even if they offer IL-8, it's for serum. It needs to be measured in your ejaculate if one wants to explore MGT infection/inflammation.

[Investigator]

I did the spermogram and the results are all within normal range, with a couple of borderlines.

14% of sperm cells have the correct morphology, with norm being "at least 14%"

Antisperm antibodies (MAR test) - that's the main reason I wanted to do the spermogram:
igA: 3.7, with norm <10%, and
igG: 1,9, with norm <10%.

Leukocytes: it says 1-2, with norm <1 million in ml. Possibly, they mean "1-2 million?" Or maybe they mean literally 1-2, with norm being less than a million?

The reason I did the spermogram is that I am watching for signs of allergy against seminal fluid, so my focus was on the MAR test and the leukocytes.

[Muon]

Leukocytes: it says 1-2, with norm <1 million in ml. Possibly, they mean "1-2 million?" Or maybe they mean literally 1-2, with norm being less than a million?

Did you clear this up?

[Investigator]

I wasn't checking POIS Center for a while, hence the slow reply. No, I didn't inquiry further, and just assumed it is really meant to be literally 1-2 - else, they would have mentioned "million". Also, a doctor quickly scrolled down the spermogram and would have commented if this was above the norm.

[Progecitor]

The case mentioned here is termed leukocytospermia, which may be indicative of ongoing inflammation due to ROS (e.g. prostatitis). Such a test may not necessarily reveal the root of POIS, but it may be a potentially useful biomarker. I wish some upcoming POIS study would address this issue.
https://poiscenter.com/forums/index.php?topic=3374.msg39428#msg39428

Leukocytospermia can be a result of infection or inflammation anywhere along the genitourinary tract, particularly the prostate gland, seminal vesicles, testicles, and bulbourethral glands, which produce the fluid in semen. The presence of these leukocytes is not completely understood, but they can be seen in the following conditions: urinary tract infection, sexually transmitted infections, autoimmune conditions, urethral strictures, varicoceles (dilated veins around the testicle), systemic illness, and use of tobacco, marijuana, or alcohol. Some studies have shown that long periods of abstinence from ejaculation can increase the number of leukocytes in the semen. Leukocytospermia is often idiopathic, which means that we don’t know where these leukocytes are coming from.
https://www.ivi-rmainnovation.com/everything-you-need-to-know-about-leukocytospermia/

ROS found in seminal plasma originates from exogenous sources as well as various endogenous ones. Leukocytes - mainly neutrophils as well as macrophages and defective spermatozoa are considered the main endogenous sources of ROS. Abnormal sperm morphology manifested by excessive residual cytoplasm around midpiece is associated with high amount of ROS affecting sperm motility.
It is well known that sperm, while in the testes are protected from immune system via the blood-testis barrier. Once they enter epididymis and move along the duct, the sperm are protected by antioxidant enzymes secreted by the epididymal epithelium into the lumen. Once ejaculation occurs, while located in the urethra sperm might come into contact with activated phagocytic leukocytes producing free radicals as a result of an infection. Inflammatory process affecting prostate or seminal vesicles such as prostatitis can trigger peroxidase-positive leucocytes and they can produce exorbitant level of ROS. This condition is described as leukocytospermia and often requires pharmacotherapy.
As a result of such inflammation an increase in proinflammatory cytokines, such as interleukin (IL)-8 occurs in tandem with a decrease in the enzymatic antioxidant SOD that leads to production of high levels of ROS. Correlation between impaired sperm function and seminal plasma with elevated levels of ROS, TNF-alpha (Tumor Necrosis Factor), IL-6 and IL-8 was found to result in an increased LPO of sperm membrane.
A reduction in semen parameters is more frequently found in men with oxidative stress (OS) and asthenozoospermia is suggested as a surrogate marker for OS.
Another marker is hyperviscosity of seminal plasma associated with increased levels of MDA and impaired antioxidant status. Urobacteria infections that affect prostate and seminal vesicles can also contribute to increased seminal plasma viscosity and an increase in ROS production. The presence of a large number of round cells imply possible oxidative stress caused by leukocytospermia or immature spermatozoa. To distinguish leukocytes from germ cells a peroxidase test is required, CD45 (leukocyte common antigen) immunostaining or measurement of seminal elastase. Visualization of excessive residual cytoplasm in abnormal sperm is indicative for high levels of ROS.
https://www.researchgate.net/profile/Ekaterina-Pavlova-2/publication/372703662_Spermatozoa_under_Oxidative_Stress_Risk_or_Benefit/links/64ff30e825ee6b7564e11e2d/Spermatozoa-under-Oxidative-Stress-Risk-or-Benefit.pdf