Chapter 13 - Semen Flashcards
1
Q
Reasons for seminal fluid analysis
A
Fertility testing, post vasectomy semen analysis, forensic analysis (alleged rape)
2
Q
Composition of semen:
____% spermatozoa
____% seminal fluid
____% prostate fluid
____% bulbourethral gland
A
5%
60-70%
20-30%
5%
3
Q
Production site of spermatozoa (spermatogenesis)
A
Seminiferous tubules (testes)
4
Q
Nurse cells for developing sperms
A
Sertoli cells
5
Q
Where does sperm maturation (sperm becomes motile) occur?
A
Epididymis
6
Q
Provide nutrients for sperm & fluid
A
Seminal vesicles
7
Q
Seminal vesicles are rich in ____ necessary for sperm motility
A
Fructose
8
Q
Acidic fluid that contains ACP, zinc, citric acid and other enzymes
A
Prostate fluid
9
Q
Secretes thick alkaline mucus that neutralizes acidity from the prostatic secretions and vagina
A
Bulbourethral gland
10
Q
In humans, it takes an average of ____ days to form a mature sperm from a primitive germ cell by this orderly process of spermatogenesis
A
74 days
11
Q
Spx collection: abstinence for how long?
A
2-3 days but not >7 days
12
Q
Effects of prolonged abstinence to spx
A
Inc vol, dec motility
13
Q
It is necessary to collect the entire ejaculate. When a part of the first portion of the ejaculate is missing, what happens with the ff (inc or dec):
- Sperm ct
- pH
- Spn liquefaction
A
- Dec
- Inc
- Will not liquefy
14
Q
It is necessary to collect the entire ejaculate. When a part of the last portion of the ejaculate is missing, what happens with the ff (inc or dec):
- Volume
- Sperm ct
- pH
- Spx clotting
A
- Dec
- Inc
- Dec
- Spx will not clot
15
Q
Best method of spx collection of semen
A
Masturbation
16
Q
Semen spx should be delivered to the lab within _____ of collection
A
Within 1 hr
17
Q
Semen spx temp during transport
A
Room temp
18
Q
Analysis of semen should be done when after collection
A
After liquefaction (30-60 mins)
19
Q
Semen spx that do not liquefy must be treated w/ _____ to break up mucus in order to obtain accurate sperm ct
A
Amylase or bromelain or alpha-chymotrypsin
20
Q
Semen spx awaiting analysis should be kept at ____ temp
A
37 deg C
21
Q
Normal semen appearance
A
Gray-white, translucent
22
Q
Odor of semen
A
Musty or bleach
23
Q
Inc white turbidity in semen is assoc w/?
A
Infection (inc WBCs)
24
Q
Brown (or red) coloration of semen is assoc with?
A
Blood (inc rbcs)
25
Yellow coloration of semen is assoc w/?
Urine contam, medication, prolonged abstinence/continence, inc flavin
26
Normal volume of semen
2-5 mL
27
Volume of semen is inc or dec in the ff:
1. Incomplete collection
2. Infertility
3. Prolonged abstinence
1. Dec
2. Dec
3. Inc
28
Normal viscosity of semen is described as
Pour in droplets
29
Increased viscosity is assoc w/?
Dec sperm motility
30
Abnormal semen viscosity is defined as having a presence of thread that is ____ long
>2 cm
31
Viscosoty of semen reporting:
____ watery
____ gel like
0
| 4
32
True or false: semen viscosity may also be reported as low, normal, high
True
33
Normal semen pH
7.2-8.0
34
Inc semen pH is assoc w/?
Infection
35
Dec semen pH is assoc w/?
Inc prostatic fluid
36
Normal value for sperm conc
>20 million sperms/mL
37
Methods in counting sperm conc
Improved Neubauer counting chamber, Makler counting chamber
38
Dilution for sperm conc using neubauer
1:20
39
Alternative diluent for sperm conc
Cold tap water
40
Diluents that can be used for sperm conc
Formalin-sodium bicarb soln, saline, distilled water, cold tap water
41
Dilution used in Makler counting chamber
None. Undiluted spn is used
42
Makler counting chamber uses ____ to immobilize sperms
Heat
43
Why is there a need to dilute semen during sperm conc?
To immobilize sperm cells
44
Regarding sperm conc, both sides of the hemocytometer are loaded and allowed to settle for ____ (how long); then they are counted and the counts should agree within ___%
3-5 mins; 10%
45
Sperm conc computation formula using shortcut method
2 wbc squares = # sperms counted x 100 000
5 rbc squares = # sperms counted x 1 000 000
46
Sperm conc formular using log method
Sperm conc per mL = (no of sperms counted x dilution) / (area x depth or 0.1)
47
1 wbc square has an area of?
1 mm^2
48
1 rbc square has an area of?
0.04 mm^2
49
Solve the ff problem:
1 sperm counted using 2 wbc squares
100 000
50
Solve the ff problem:
1 sperm counted using 5 rbc squares
1 000 000
51
Normal value for sperm count
> or = 40 million per ejaculate
52
Formula for sperm count
Sperm conc x spx volume
53
Solve the ff:
Compute sperm count for a sample w/ a volume of 2 mL/ejaculate and a sperm conc of 20M sperms/mL
40 M sperms/ejaculate
54
Sperm motility is read in what objective, under how many total manification, and how many fields?
20 fields of HPF which has 1000 total magnification
55
Normal value for sperm motility
>50%
56
Qualitative normal value for sperm motility
2+
57
Sperm motility grading:
1. No forward progression
2. No movement
3. Rapid straight line motility
4. Slower speed some lateral movement
5. Slow forward progression, noticeable lateral movement
1. 1.0 (c)
2. 0 (d)
3. 4.0 (a)
4. 3.0 (b)
5. 2.0 (b)
58
CASA stands for
Computer-assisted semen analysis
59
CASA provides objective determination of both sperm ____ and ____
Velocity and trajectory (direction of motion)
60
____ and ____ are also included in the analysis of CASA
Sperm conc & morphology
61
Routine criteria normal value sperm morphology
>30% normal forms
62
Kruger’s strict criteria normal value sperm morphology
>14% normal forms
63
Stain of choice for sperm morphology
Papanicolau’s stain
64
Stains for sperm morphology
Wright’s stain, Giemsa stain, Papanicolau’s stain
65
Normal head shape
Oval shaped
66
Abnormal head shape will result to
Poor ovum penetration
67
In which part of sperm does it contain mitochondria?
Midpiece or neck
68
Abnormal tail will result to
Poor motility
69
Size of sperm head
5 x 3 um
70
Size of midpiece
7 um
71
Size of tail (neck included)
45 um
72
Size of tail (neck excluded)
38 um
73
The acrosomal cap covers ____ (how much) of the head
1/2
74
The acrosomal cap covers ____ (how much) of the nucleus
2/3
75
Hardening of veins that drain the testes
Varicocele
76
Sperm head in varicocele
Tapered head
77
Most common cause of male infertility
Varicocele
78
Test for sperm viability
Modified Bloom’s test
79
Reagents for modified Bloom’s test
Eosin and Negrosin
80
In modified Bloom’s test, spx is tested within ____ of ejaculation
1 hr
81
Regarding modified Bloom’s test, living sperms will stain ___ while dead sperms will stain ____
Unstained or bluish white
Red
82
Normal value for modified Bloom’s test
50% living sperms
83
Seminal fluid fructose is tested within ___
2 hrs
84
If spx for seminal fluid fructose testing cannot be tested within 2 hrs, ____ to prevent fructolysis
Frozen
85
Screening test for seminal fluid fructose
Resorcinol / Seliwanoff’s test
86
Positive resorcinol test or Seliwanoff’s test result for seminal fluid fructose
Orange-red color
87
2 tests for antisperm antibodies
Mixed agglutination rxn and immunobead test
88
Antisperm antibodies are detected in which spx?
Semen, cervical mucosa, serum
89
Mixed agglutination rxn detects the presence of ___
IgG Ab
90
Immunobead test detects the presence of ___
IgG, IgM and IgA Abs
91
Normal result for mixed agglutination rxn
<10% motile sperm attached to the particles
92
Normal result for immunobead test
Presence of beads on <50% of the sperm
93
Which test demonstrates what area of sperm the autoAb are affecting
A. Immunobead test
B. Mixed agglutination rxn
A. Immunobead test
94
Dec values of fructose indicate?
Lack of seminal fluid
95
Dec value of neutral alpha glucosidase indicate
Epididymis disorder
96
Identify the normal values of the ff
1. Zinc
2. Citric acid
3. Fructose
4. Neutral alpha-glucosidase
5. Acid phosphatase
1. > or = 2.4 umol/ejaculate
2. > or = 52 umol/ejaculate
3. > or = 13 umol/ejaculate
4. > or = 20 umol/ejaculate
5. > or = 200 umol/ejaculate
97
Dec value of ACP and citric acid indicate
Lack of prostatic fluid
98
Dec value of zinc indicate
Lack of prostatic fluid
99
Dec levels of ____ and ____ aside from neutral alpha-glucosidase also indicate an epididymis disorder
Glycerophosphpcholine and L-carnitine
100
Dec value of ____ also indicates a lack of prostatic fluid besides zinc, ACP and citric acid
Glutamyl transpeptidase level
101
Enumerate the stages of sperm maturation (youngest to oldest)
```
Spermatogonium
Primary spermatocyte
Secondary spermatocyte
Spermatid
Spermatozoon
```
102
Refers to wbcs and spermatids
Round cells
103
Microbial testing round cells normal value
>1 M / mL
104
>1 M wbcs / mL of round cells indicate
Infection
105
> 1 M spermatid / mL ofnround cells indicate
Disruption of spermatogenesis
106
Microbial testing of semen spx tests for
C. trachomatis, M. hominis, U. urealyticum
107
Medico-legal tests (tests for detection of semen)
Hint: there are 8 of them
Microscopic exam, fluorescence under UV light, ACP determination, glycoprotein p30, florence test, barbiero’s test, ABO blood grping, DNA analysis
108
Color of living sperm and dead sperm in fluorescence under uv light
Green -living
| Red -dead
109
More specific method to detect semen
Glycoprotein p30 (PSA)
110
Florence tests for ___
Choline
111
Barbiero’s tests for
Spermine
112
Reagents of florence test
Iodine crystals plus potassium iodide
113
Positive result for florence test
Dark brown rhombic crystal
114
Rgts of Barbiero’s test
Saturated picric acid plus trichloroacetic acid
115
Positive result for Barbiero’s test
Yellow leaf-like crystal
116
Very specific
A. Florence
B. Barbiero
B. Barbiero
117
Cutting of vas deferens so that the ejac will not contain any sperm cell
Vasectomy
118
The only concern for post vasectomy semen analysis
Presence or absence of sperm
119
Post vasectomy semen analysis is done ____ after vasectomy and continued until ____ spx show no sperm
2 mos after; 2 consecutive monthly spx
120
Regarding post vasectomy semen analysis, a negative wet prep is followed by spx centrifugation for ___ (how long) and exam of sediment
10 mins
121
Identify the ff terms described:
1. Absence of sperm cells
2. No ejaculate
3. Dec sperm conc
4. Immotile or dead sperm cell
1. Azoospermia
2. Aspermia
3. Oligospermia
4. Necrospermia
122
# Fill in the normal values for semen analysis
1. Volume
2. Viscosity
3. pH
4. Sperm conc
5. Sperm count
6. Motility
7. Quality
8. Morphology
9. Round cells
1. 2-5 mL
2. Pour in droplets
3. 7.2-8.0
4. >20 million / mL
5. >40 million / ejaculate
6. >50% within 1 hr
7. >2.0 or a, b, c
8. >30% normal forms (routine criteria); >14% normal forms (strict criteria)
9. <1.0 million/mL
123
Assessment of sperm cells (describe procedures to assess the ff)
1. Sperm morphology
2. Sperm viability
3. Sperm count
4. Sperm motility
1. Make a smear in slide, stain w/ Papanicolau’s, Wright’s or Giemsa
2. Stain w/ Eosin-Negrosin
3. Dilute w/ chilled tapwater or formalin-bicarb soln then charge in a Neubauer counting chamber
4. Place a drop of semen in a slide and cover it with coverslip
124
Alternative sperm motility criteria semen analysis
1. No movement
2. Sperm moving linearly or in a large circle
3. Sperm moving w/ an absence of progression
1. Immotility
2. Progressive motility (PM)
3. Nonprogressive motility (NP)
125
Additional testing for abnormal semen analysis: identify possible abnormality and give the test to use
1. Dec motility w/ normal count
2. Dec count
3. Dec motility w/ clumping
4. Normal analysis w/ continued infertility
1. Viability; Eosin-nigrosin stain
2. Lack of seminal vesicle support medium; fructose level
3. Male antisperm Ab; MAR and immunobead and sperm aggl’n w/ male serum
4. Female antisperm Ab; sperm aggl’n w/ female serum
126
Identify the ff sperm fxn tests:
1. Observing sperm penetration ability of partner’s midcycle cervical mucus
2. Evaluation of the acrosome to produce enzymes essential for ovum penetration
3. Sperms are incubated w/ species-nonspecific hamster eggs and penetration is observed microscopically
4. Sperms exposed to low sodium conc are evaluated for membrane integrity and sperm viability
1. Cervical mucus penetration
2. In vitro acrosome rxn
3. Hamster egg penetration
4. Hypo-osmotic swelling
127
What are tested by each test?
1. Cervical mucus penetration
2. In vitro acrosome rxn
3. Hamster egg penetration
4. Hypo-osmotic swelling
1. Sperm penetration
2. Enzyme production of acrosome for ovum penetration
3. Penetration
4. Membrane integrity & sperm viability
128
_____ secrete testosterone
Leydig cells
129
_____ secrete inhibin (inhibits FSH synthesis)
Sertoli cells
130
Shortly after ejaculation, the semen coagulates bec of the action of a clotting enzyme, formed in the ____, on a fibrinogen-like precursor substance that is produced by the ____
Prostate; seminal vesicle
131
When performing fertility testing, WHO recommends that _____ (how many) samples be collected not ____ (how many days or wks) apart with ___ (how many) abnormal samples considered significant
2 or 3
<7 days or >30 wks
2
132
Failure of liquefaction to occur within ____ mins may be caused by a deficiency in ____
60 mins; prostatic enzymes
133
Semen pH should be measured within ____ of ejac due to the loss of____ that occurs
1 hr
| CO2
134
Allow semen to settle on the slide for ____ (how long) before testing for sperm motility
1 min
135
Use ____ deg angle when preparing smears for sperm morphology
45 deg angle
136
Granulocytes can be differentiated from spermatogenic cells & lympho using ____
Peroxidase stain
137
Motile sperm can be detected for up to ___ (how long) after intercourse, whereas nonmotile sperm can persist for ___ (how long)
24 hrs
| 3 days
138
As the sperm die off, only the ___ (which part of sperm) remain and may be present for ___ (how long) after intercourse
Head
| 7 days
