Test Catalog

Test Id : MSTC1

Strict Criteria Sperm Morphology for Infertility Diagnosis and Treatment, Semen

Useful For
Suggests clinical disorders or settings where the test may be helpful

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

Method Name
A short description of the method used to perform the test

Kruger Criteria Strict Morphology

NY State Available
Indicates the status of NY State approval and if the test is orderable for NY State clients.


Reporting Name
Lists a shorter or abbreviated version of the Published Name for a test

Strict Sperm Morphology, Slide

Lists additional common names for a test, as an aid in searching

Fertility Testing

Infertility Testing

Semen Analysis

Sperm Analysis

Sperm Motility

Specimen Type
Describes the specimen type validated for testing


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).


Question ID Description Answers
OSSC1 Sperm Count/mL(x10(6), XX.X)

Specimen Required
Defines the optimal specimen required to perform the test and the preferred volume to complete testing

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
Defines the amount of sample necessary to provide a clinically relevant result as determined by the testing laboratory. The minimum volume is sufficient for one attempt at testing.

A minimum count of sperm is needed; lab will determine

Reject Due To
Identifies specimen types and conditions that may cause the specimen to be rejected

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

Specimen Stability Information
Provides a description of the temperatures required to transport a specimen to the performing laboratory, alternate acceptable temperatures are also included

Specimen Type Temperature Time Special Container
Semen Ambient

Useful For
Suggests clinical disorders or settings where the test may be helpful

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

Clinical Information
Discusses physiology, pathophysiology, and general clinical aspects, as they relate to a laboratory test

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
Describes reference intervals and additional information for interpretation of test results. May include intervals based on age and sex when appropriate. Intervals are Mayo-derived, unless otherwise designated. If an interpretive report is provided, the reference value field will state this.

Normal forms: > or =4.0%

Germinal cells/mL

<4 x 10(6) (normal)

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


<1 x 10(6) (normal)

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

Provides information to assist in interpretation of the test results

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.

Discusses conditions that may cause diagnostic confusion, including improper specimen collection and handling, inappropriate test selection, and interfering substances

No significant cautionary statements.

Clinical Reference
Recommendations for in-depth reading of a clinical nature

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
Describes how the test is performed and provides a method-specific reference

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)

PDF Report
Indicates whether the report includes an additional document with charts, images or other enriched information


Day(s) Performed
Outlines the days the test is performed. This field reflects the day that the sample must be in the testing laboratory to begin the testing process and includes any specimen preparation and processing time before the test is performed. Some tests are listed as continuously performed, which means that assays are performed multiple times during the day.

Monday through Friday

Report Available
The interval of time (receipt of sample at Mayo Clinic Laboratories to results available) taking into account standard setup days and weekends. The first day is the time that it typically takes for a result to be available. The last day is the time it might take, accounting for any necessary repeated testing.

2 to 4 days

Specimen Retention Time
Outlines the length of time after testing that a specimen is kept in the laboratory before it is discarded

At least 6 months

Performing Laboratory Location
Indicates the location of the laboratory that performs the test


Several factors determine the fee charged to perform a test. Contact your U.S. or International Regional Manager for information about establishing a fee schedule or to learn more about resources to optimize test selection.

  • Authorized users can sign in to Test Prices for detailed fee information.
  • Clients without access to Test Prices can contact Customer Service 24 hours a day, seven days a week.
  • Prospective clients should contact their account representative. For assistance, contact Customer Service.

Test Classification
Provides information regarding the medical device classification for laboratory test kits and reagents. Tests may be classified as cleared or approved by the US Food and Drug Administration (FDA) and used per manufacturer instructions, or as products that do not undergo full FDA review and approval, and are then labeled as an Analyte Specific Reagent (ASR) product.

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
Provides guidance in determining the appropriate Current Procedural Terminology (CPT) code(s) information for each test or profile. The listed CPT codes reflect Mayo Clinic Laboratories interpretation of CPT coding requirements. It is the responsibility of each laboratory to determine correct CPT codes to use for billing.

CPT codes are provided by the performing laboratory.


LOINC® Information
Provides guidance in determining the Logical Observation Identifiers Names and Codes (LOINC) values for the order and results codes of this test. LOINC values are provided by the performing laboratory.

Test Id Test Order Name Order LOINC Value
MSTC1 Strict Sperm Morphology, Slide 48812-2
Result Id Test Result Name Result LOINC Value
Applies only to results expressed in units of measure originally reported by the performing laboratory. These values do not apply to results that are converted to other units of measure.
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 Setup Resources

Setup Files
Test setup information contains test file definition details to support order and result interfacing between Mayo Clinic Laboratories and your Laboratory Information System.

Excel | Pdf

Sample Reports
Normal and Abnormal sample reports are provided as references for report appearance.

Normal Reports | Abnormal Reports

SI Sample Reports
International System (SI) of Unit reports are provided for a limited number of tests. These reports are intended for international account use and are only available through MayoLINK accounts that have been defined to receive them.

SI Normal Reports | SI Abnormal Reports