2S [LEC]: Semen Analysis Flashcards
A medical field that deals with male health, specifically problems relating to the male reproductive system and urologic concerns unique to men
Andrology
Structure that stored the seminal fluid
Seminal vesicle
Structure that propels sperm to the prostate gland
Ejaculatory duct
Structure where spermatids would mature
Epididymis
Small ovoid organs that function as both exocrine and endocrine glands
Testes
Cells in the testes that nourishes the germ cells during the differentiation
Sertoli cells
A convoluted comma shaped structure at the posterior side of the testis
Epididymis
Paired gland in the scrotum that contain seminiferous tubules for sperm secretion
Testes
The major exocrine function of the testes is the production of ___
Sperm
The major endocrine function of the testes is the production of ___
Testosterone
Part of the epididymis that stored the sperm before it undergoes its final maturation phase
Head
Part of the epididymis that where maturation occurs
Duct of epididymis
Part of the epididymis that connects to the ductus deferens which eventually leads to the ejaculatory duct
Tail
How many percent of the semen is produced in the seminal vesicle
60-70%
Component of the semen that is metabolized to provide energy in propelling the flagella
Fructose
Component of the semen that is responsible in the gray appearance of the semen
Flavin
Location of the mitochondria in the sperm
Neck region
Most important in the liquefaction of semen
Proteolytic enzymes
How many percent of the semen is produced in the prostate gland?
20-30%
The one responsible in contractions during ejaculation
Prostate gland
How many percent of the semen is produced in the bulbuorethral glands?
5%
The gland responsible in neutralizing acidity from prostate secretions and vagina
Bulbourethral gland
Effect when the first portion of the ejaculate is lost in sperm count, pH, and liquefaction
Low sperm count
High pH
No liquefaction
Effect when the last portion of the ejaculate is lost in semen volume, sperm count, pH, and liquefaction
Low semen volume
High sperm count
Low pH
No clotting
In semen collection, sexual abstinence is advised for how long?
2-7 days
In semen collection, how many samples must be collected and what should be the interval of collection
2-3 samples
7 days to 3 weeks apart
Where should the semen sample be collected?
Warm sterile glass or plastic containers
Specimen should be kept at room temperature and transported to the laboratory within how long?
1 hour
Optimal temperature of semen samples awaiting analysis
37C
Liquefaction time of semen
30 mins to 1 hour
Method of collection for semen analysis
Masturbation
Semen collection method that is only recommended in married couples if the first method is not applicable
Coitus interruptus
T/F: In coitus interruptus, low pH of the vaginal fluid may affect sperm motility
True
Semen analysis is also known as ___
Sperm count test
Analyzes the health and viability of a man’s sperm
Semen analysis
The fluid containing sperm that’s released during ejaculation
Semen
Three major factors of sperm health measured by semen analysis
Number of sperm
Shape of sperm
Movement of the sperm (sperm motility)
Normal appearance of semen
Grayish-white
Normal clarity of semen
Translucent
Normal odor of semen
Must, Bleach-like
A clear semen indicates ___
Low semen concentration
A turbid semen indicates ___
Presence of WBCs
Presence of blood in the semen shows what color?
Red-brown
Urine contamination, jaundice, and medications in semen shows what color?
Yellow
The presence of WBCs can also be screened by ___
Leukocyte esterase strip
What reagent is used to liquefy the semen if it did not liquefy for 30-60 mins?
Proteolytic enzymes (Dulbecco’s phosphate buffered saline [DPBS], a-chymotrypsin, bromelin)
T/F: Jelly-like granules in the semen or gelatinous bodies may be present in liquefied semen, which has clinical significance
False (no clinical significance)
Normal volume of a semen specimen
2-5 mL
Low volume semen specimen is frequently associated with ___
Infertility, improper functioning of seminal vesicle
Refers to the consistency of the semen
Viscosity
T/F: Viscosity of closely related to liquefaction
True
A clumped and highly viscous semen is indicative of ___
Incomplete liquefaction
Droplets longer than ___ are abnormal and present low volume of prostatic fluid
2 cm
Normal pH range of semen
7.2 to 8.0
A pH level of ___ in semen is indicative of infection within the reproductive tract
> 8.0
A pH level of ___ indicates increased prostatic fluid, ejaculatory duct obstruction, poorly developed seminal vesicle, or contaminated specimen
<7.2
pH of semen should be measured within 1 hour of ejaculation due to the loss of ___ that occurs
CO2
Most common dilution used in semen analysis
1:20
Diluting fluid used in semen analysis
Sodium bicarbonate + formalin
T/F: Saline and distilled water may also be used as diluting fluids in semen analysis
True (as long as it is cold)
Unit of measure in sperm concentration
Millions per mL
In sperm concentration and sperm count, both sides are loaded in the hemacytometer and is settled for how long before counting?
3-5 mins
In sperm count, >1M WBCs/mL is an indication of ___
Inflammation/ infection = infertility
In sperm count, >1M spermatids/mL is an indication of ___
Disruption of spermatogenesis, viral infection, exposure to chemicals, genetic disorders
In sperm count, the counts should agree within ___
10% (200)
The common factor for computing for sperm count
1 000 000
Microscopes used in sperm count
Phase contrast
Dark-field
Unit of measure in sperm count
Million/ ejaculate
Reference range for sperm concentration
> 20-250 M/mL
Reference range for sperm count
> 40 M/ejaculate
T/F: A sperm count estimate may be done through either evaluating 10 HPOs or examining 100 sperm per slide
False (20 HPOs, 200 sperms)
In sperm motility, a minimum motility of ___ with a grade of ___ after 1 hour is still considered normal
50%
2.0
Part of the sperm that is critical for ovum penetration
Acrosomal cap
How much of the sperm nucleus is covered by the acrosomal cap?
2/3
The thickest portion of the sperm, approximately 7um and is surrounded by mitochondrial sheath
Midpiece
Part of the sperm that produced energy for motility
Mitochondrial sheath
Sperm morphology is evaluated under which objective in the microscope?
OIO
A thinly smeared sperm slide is stable for how long?
24 hours
In evaluating the sperm morphology, at least how many sperm should be evaluated?
200
This is an integral part of evaluations in assisted production, but is not routinely performed but recommended by WHO
Kruger’s strict criteria
In Kruger’s strict criteria, how many normal forms are usually reported?
> 14%
In routine criteria, how many normal forms are usually reported?
> 30%
Sperm vitality is assessed within how many hours of ejaculation?
1 hour
Stain used in assessing the sperm vitality
Eosin-nigrosin stain
Number of sperm evaluated in sperm vitality
Dead cells per 100 sperm
The normal vitality of sperm would exhibit how many percent of living cells?
50% or more
Seminal fluid fructose is evaluated within how many hours of collection?
2 (or frozen to prevent fructolysis)
The resorcinol test for seminal fluid fructose would produce what color?
Orange
Normal level of fructose in the sperm
> or equal to 13 umol per ejaculate
Can both be present in men and women and can be a possible cause of infertility
Antisperm antibodies
Antisperm antibodies are produced in response to disruption of ___
Blood-testis barrier
Suspected when clumps of sperms are observed during a routing semen analysis
Antisperm antibodies
A normal semen analysis with continued infertility may be indicative of ___
Antisperm antibodies
Causes sperm to stick to each other in a head-to-head, head-to-tail, or tail-to-tail pattern
Antisperm antibodies
Screening procedure used primarily to detect the presence of IgG antibodies
Mixed agglutination reaction (MAR) test
In MAR test, the sperm is incubated with ___ and ___
IgG AHG
Suspension of latex particle/ treated RBCs coated with IgG
Positive result for MAR test
Microscopically visible clumps of sperm and particles or cells
Normal MAR test result
<10% of motile sperm attached to the particles
Used to detect the presence of IgG, IgM, and IgA antibodies
Immunobead test
Demonstrates what area of the sperm the autoantibodies are affecting
Immunobead test
In immunobead test, sperm are mixed with ___ beads coated with either anti-IgG, anti-IgM, or anti-IgA
Polyacrylamide
Normal result for immunobead test
Presence of beads on >50% of the sperm
Chemical testing for rape/sexual assault is enhanced with ___
Xylene
Chemical testing for rape/sexual assault is viewed under what microscope?
Phase microscopy
Sperm motility can be seen up to ___
24 hours
Non-motile sperm can be seen until ___
3 days
The head of the sperm will remain for up to ___ even if the sperm is dead
7 days
The more specific chemical testing for rape/sexual assault
p30 (prostatic specific antigen [PSA])
What other tests can be done after chemical testing for rape/sexual assault to obtain further information?
ABO blood grouping
DNA analysis
An additional test for sperm function when the sperm is incubated with species-nonspecific hamster eggs and microscopically observed for penetration
Hamster Egg Penetration
An additional test for sperm function which is an observation if the sperm is able to penetrate the midcycle cervical mucus of the partner
Cervical mucus penetration
An additional test for sperm function where the sperm is exposed to low-sodium concentrations and are evaluated for membrane integrity and sperm viability
Hypo-osmotic swelling
An additional test for sperm function which evaluates the acrosome to produce enzymes essential for ovum penetration
In vitro acrosome reaction
Provides standardized procedures for semen analysis
WHO
Provides proficiency testing program, including sperm concentration, vitality, and morphology
College of American Pathologists (CAP)
American Association of Bioanalysts
