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AUBF > F1: Semen Analysis (Part 3: Macroscopic and Microscopic Examination) > Flashcards

F1: Semen Analysis (Part 3: Macroscopic and Microscopic Examination) Flashcards

1
Q

MACROSCOPIC EXAMINATION

Macroscopic examination involves 5 parameters, what are those?

A
  • Appearance/ Color
  • Volume
  • Liquefaction Time
  • Viscosity
  • pH

VALVP

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2
Q

APPEARANCE/COLOR

Identify color based on description of appearance:

Gray white/pearly white translucent w/ musty odor or chlorox like smell

MACROSCOPIC EXAMINATION

A

Normal

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3
Q

APPEARANCE/COLOR

Identify color based on description of appearance:
WBCs which indicate infection

MACROSCOPIC EXAMINATION

A

Turbid

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4
Q

APPEARANCE/COLOR

Identify color based on description of appearance:
indicate low sperm count

MACROSCOPIC EXAMINATION

A

Clear

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5
Q

APPEARANCE/COLOR

Identify color based on description of appearance:
indicate urine contamination, prolonged abstinence, medications

MACROSCOPIC EXAMINATION

A

Yellow

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6
Q

APPEARANCE/COLOR

Identify color based on description of appearance:

Flavin

MACROSCOPIC EXAMINATION

A

Gray

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7
Q

APPEARANCE/COLOR

Identify color based on description of appearance:

RBCs

MACROSCOPIC EXAMINATION

A

red

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8
Q

APPEARANCE/COLOR

Yellow color of sperm

a. Urine contamination
b. Prolonged abstinence
c. Medication
d. ALL
e. a and b
f. b and c
g. nOTA

MACROSCOPIC EXAMINATION

A

d. ALL

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9
Q

VOLUME

Semen is measured in what container and how many mL of increments?

MACROSCOPIC EXAMINATION

A

container: clean graduated cylinder in 0.1 mL increments

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10
Q

VOLUME

Identify if Normal, Low volume, High volume

2-5 mL per ejaculate

MACROSCOPIC EXAMINATION

A

Normal

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11
Q

VOLUME

Identify if Normal, Low volume, High volume

  • Non-adherence to 2-day abstinence
  • Infertility
  • Problem in the seminal vesicle

MACROSCOPIC EXAMINATION

A

Low volume

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12
Q

VOLUME

Identify if Normal, Low volume, High volume

Signifies prolonged abstinence

MACROSCOPIC EXAMINATION

A

HIgh volume

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13
Q

LIQUEFACTION TIME

Identify if Normal liquefaction time or Prolonged liquefaction time

30 – 60 minutes after collection

MACROSCOPIC EXAMINATION

A

Normal liquefaction time

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14
Q

LIQUEFACTION TIME

Identify if Normal liquefaction time or Prolonged liquefaction time

Indicates deficiency in prostatic enzymes

MACROSCOPIC EXAMINATION

A

Prolonged liquefaction time

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15
Q

LIQUEFACTION TIME

T or F

SPecimen should be analyzed before liquefaction

MACROSCOPIC EXAMINATION

A

F (should be analyzed after liquefaction)

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16
Q

LIQUEFACTION TIME

If after 2 hours specimen has not liquefied, what (2) reagents should be added?

MACROSCOPIC EXAMINATION

A
  • Dulbecco’s phosphate-buffered saline
  • Proteolytic enzymes (alphachymotrypsin bromelain)
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17
Q

LIQUEFACTION TIME

T or F

Liquefaction should be timed

MACROSCOPIC EXAMINATION

A

T

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18
Q

VISCOSITY

T or F

To observe viscosity, pour the specimen and observe how it pours OR by using pasteur pipette

MACROSCOPIC EXAMINATION

A

T

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19
Q

VISCOSITY

Identify if Normal or Highly viscous

Pours like droplets

MACROSCOPIC EXAMINATION

A

Normal

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20
Q

VISCOSITY

Identify if Normal or Highly viscous

Droplets with threads of >2cm

MACROSCOPIC EXAMINATION

A

Highly viscous

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21
Q

VISCOUS

Rating of 0 or 4 ?

Watery

MACROSCOPIC EXAMINATION

A

0

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22
Q

VISCOUS

Rating of 0 or 4 ?

Gel-like

MACROSCOPIC EXAMINATION

A

4

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23
Q

VISCOUS

T or F

Viscosity can also be reported as low, normal, or high viscosity

MACROSCOPIC EXAMINATION

A

T

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24
Q

VISCOUS

Highly clumped and viscous semen indicates what motility ?

MACROSCOPIC EXAMINATION

A

slower sperm motility

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25
Q

pH

pH of semen can be detected by what (2) methods?

MACROSCOPIC EXAMINATION

A
  • pH pad of urinalysis reagent strip
  • pH paper
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26
Q

pH

Identify if High pH, Normal pH, Low pH

indicates infection (reproductive tract)

MACROSCOPIC EXAMINATION

A

High pH

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27
Q

pH

Identify if High pH, Normal pH, Low pH

7.2 – 8.0

MACROSCOPIC EXAMINATION

A

Normal

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28
Q

pH

Identify if High pH, Normal pH, Low pH

  • Increased prostatic fluid
  • Obstruction of the ejaculatory duct
  • Problem in the seminal vesicle

MACROSCOPIC EXAMINATION

A

Low pH

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29
Q

MICROSCOPIC EXAMINATION

Microscopic examination involves 3 parameters, what are those?

A
  • Motility
  • Morphology
  • Count
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30
Q

SPERM CONCENTRATION/COUNT

Identify if Normal sperm concentration, Borderline concentration, Normal sperm count:

20-250 Million sperm/mL

MICROSCOPIC EXAMINATION

A

Normal sperm concentration

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31
Q

SPERM CONCENTRATION/COUNT

Identify if Normal sperm concentration, Borderline concentration, Normal sperm count:

10-20 Million/mL

MICROSCOPIC EXAMINATION

A

Borderline concentration

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32
Q

SPERM CONCENTRATION/COUNT

Identify if Normal sperm concentration, Borderline concentration, Normal sperm count:

At least 40 Million/ejaculate

MICROSCOPIC EXAMINATION

A

Normal sperm count

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33
Q

SPERM CONCENTRATION/COUNT

Formula of sperm count?

MICROSCOPIC EXAMINATION

A

Concentration x Volume

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34
Q

SPERM CONCENTRATION/COUNT

Common dilution is?

MICROSCOPIC EXAMINATION

A

1:20

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35
Q

SPERM CONCENTRATION/COUNT

Common dilution of 1:20 is achieved using what equipment?

MICROSCOPIC EXAMINATION

tatlo

A

Mechanical (positive-displacement) pipette/Automatic pipette/ WBC pipette

Pwede RBC pipette pero mahirap gamitin dahil white(semen) to white(background), mahihirapan basahin

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36
Q

SPERM CONCENTRATION/COUNT

T or F

Dilution is done to mobilize sperm prior to counting

MICROSCOPIC EXAMINATION

A

F (dilution is to immobilize sperm before counting)

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37
Q

SPERM CONCENTRATION/COUNT

What are the (3) diluting fluids used?

MICROSCOPIC EXAMINATION

A
  • Sodium bicarbonate
  • Formalin
  • Chilled water
  • Saline
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38
Q

SPERM CONCENTRATION/COUNT

Most common which dissolves mucus

MICROSCOPIC EXAMINATION

(3) diluting fluids used

A

Sodium bicarbonate

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39
Q

SPERM CONCENTRATION/COUNT

Most common which immobilizes sperm

MICROSCOPIC EXAMINATION

(3) diluting fluids used

A

Formalin

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40
Q

SPERM CONCENTRATION/COUNT

Used to kill sperm to stop motility

MICROSCOPIC EXAMINATION

(3) diluting fluids used

A

Chilled water

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41
Q

SPERM CONCENTRATION/COUNT

  • Used in counting sperm cells
  • Only the mature cells are counted, not the immature “round cells”

MICROSCOPIC EXAMINATION

A

Neubauer chamber

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42
Q

SPERM CONCENTRATION/COUNT: Neubauer chamber

T or F

In neubauer chamber, count the round cells and not the cells with head or tail

MICROSCOPIC EXAMINATION

A

F (reverse; count cells with head or tail or MATURE CELLS, NOT the round cells or IMMATURE CELLS)

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43
Q

SPERM CONCENTRATION/COUNT

This defines the square’s boundary (black line, left panel)

MICROSCOPIC EXAMINATION

A

middle of the 3 lines

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44
Q

SPERM CONCENTRATION/COUNT: Neubauer chamber

T or F

All spermatozoa within the central square are counted, as well as those with their heads between the 2 inner lines (white circles), including whose heads lie between the outer 2 lines (black circles)

MICROSCOPIC EXAMINATION

A

F (All spermatozoa within the central square are counted, as well as those with their heads between the 2 inner lines (white circles), but not those whose heads lie between the outer 2 lines (black circles))

45
Q

SPERM CONCENTRATION/COUNT: Neubauer chamber

is counted only if that line is the lower or left-hand line of the square (white circle, middle panel) but not if it is the upper or right hand line of the square

MICROSCOPIC EXAMINATION

A

A spermatozoon with most of its head lying on the central line

46
Q

SPERM CONCENTRATION/COUNT: Neubauer chamber

Sperm concentration per mL formulation

Using 2 WBC squares

MICROSCOPIC EXAMINATION

A

Sperm concentration per mL =

no. of cells counted x DF (20) x 1,000 / no. of squares (2) x volume of 1 square (0.1)

OR

no. of cells counted x DF (20) x 1,000 / no. of squares (2)

no. of cells x 20 x 1,000 / 2 x 0.1

MICROSCOPIC EXAMINATION

47
Q

SPERM CONCENTRATION/COUNT: Neubauer chamber

Simplified concentration per mL formula

Using 2 WBC squares

MICROSCOPIC EXAMINATION

A

no. of cells counted x 100,000

48
Q

SPERM CONCENTRATION/COUNT: Neubauer chamber

T or F

When using 5 RBC squares one should load one side of hemocytometer

Using 5 RBC squares

MICROSCOPIC EXAMINATION

A

f (Load both sides of hemocytometer)

49
Q

SPERM CONCENTRATION/COUNT: Neubauer chamber

After loading both sides, sample should be allowed to settle for how many minutes?

MICROSCOPIC EXAMINATION

A

3 to 5 minutes

50
Q

SPERM CONCENTRATION/COUNT: Neubauer chamber

After settling, two counts should be?

MICROSCOPIC EXAMINATION

A

Averaged

51
Q

SPERM CONCENTRATION/COUNT: Neubauer chamber

T or F

Average of 2 counts should agree within 10%

MICROSCOPIC EXAMINATION

A

T

52
Q

SPERM CONCENTRATION/COUNT: Neubauer chamber

If average of 2 counts do not agree, what should one do?

MICROSCOPIC EXAMINATION

A

repeat dilution and counting multiply the counted
sperm by 1,000,00

53
Q

SPERM CONCENTRATION/COUNT: Neubauer chamber

Sperm concentration per mL formulation

Using 5 RBC squares

MICROSCOPIC EXAMINATION

A

Sperm concentration per mL = no. of cells counted x DF (20) x 1,000 / no. of sqaures (5) x volume of 1 square (0.004)

no. of cells x 20 x 1,000 / 5 x 0.004

54
Q

SPERM CONCENTRATION/COUNT: Neubauer chamber

Simplified concentration per mL formula

Using 5 RBC squares

MICROSCOPIC EXAMINATION

A

no. of cells counted x 1,000,000

55
Q

SPERM CONCENTRATION/COUNT: Neubauer chamber

  • for counting sperm cells
  • Uses a cover plate with 1mm2 grid divided into 100 squares
  • undiluted specimen
  • No additional factors are necessary for calculation
  • number of spermatozoa counted in any strip of 10 squares of the grid indicates their concentration in
    millions/mL

MICROSCOPIC EXAMINATION

A

Makler counting chamber

56
Q

SPERM CONCENTRATION/COUNT

Makler counting chamber
a. cover plate with 1mm grid divided into 1000 squares
b. diluted specimen
c. additional factors
d. ALL
e. NOTA

MICROSCOPIC EXAMINATION

A

e. NOTA

a. cover plate with 1mm2 grid divided into 100 squares
b. **undiluted **specimens
c. NO additional factors

57
Q

SPERM CONCENTRATION/COUNT

How are number of spermatozoa counted?

MICROSCOPIC EXAMINATION

MAKLER COUNTING CHAMBER

A

any strip of 10
squares of the grid

concentration in millions/mL

58
Q

SPERM CONCENTRATION/COUNT

Causes of low sperm count could be because of (3) factors, what are those?

MICROSCOPIC EXAMINATION

MAKLER COUNTING CHAMBER

A

Medical causes, Environmental causes, Health and lifestyle and other causes

59
Q

SPERM CONCENTRATION/COUNT

Medical, Environmental, Health/Lifestyle/other causes?

  • Varicocele
  • Ejaculation problems
  • Anti-sperm Antibodies
  • Tumors
  • Undescended testicles
  • Defects of tubules that transport sperm
  • Chromosome defects
  • Certain medications
  • Prior surgeries

MICROSCOPIC EXAMINATION

MAKLER COUNTING CHAMBER

A

Medical causes

60
Q

SPERM CONCENTRATION/COUNT

Medical, Environmental, Health/Lifestyle/other causes?

  • Industrial chemicals
  • Heavy metal exposure
  • Radiation or X-rays
  • Overheating the testicles

MICROSCOPIC EXAMINATION

MAKLER COUNTING CHAMBER

A

Environmental causes

61
Q

SPERM CONCENTRATION/COUNT

Medical, Environmental, Health/Lifestyle/other causes?

  • Drug use
  • Alcohol use
  • Tobacco smoking
  • Emotional stress
  • Weight

MICROSCOPIC EXAMINATION

MAKLER COUNTING CHAMBER

A

Health/Lifestyle/other causes

62
Q

SPERM MOTILITY

T or F

Sperm must penetrate the cervical mucosa to the uterus, fallopian tubes and ovum

MICROSCOPIC EXAMINATION

MAKLER COUNTING CHAMBER

A

T

63
Q

SPERM MOTILITY

Sperm motility can be detected using what (2) methods?

A
  • Hanging drop method
  • Sperm vitality
64
Q

SPERM MOTILITY: 2 detection methods

  • Undiluted, well mixed and fully-liquefied semen
  • 10ul and 22 X 22 coverslip, concave slide
  • % of motile sperm cells ( >50% within 1 hour)

MICROSCOPIC EXAMINATION

A

Hanging drop method

65
Q

SPERM MOTILITY: 2 detection methods

volume of sample and what size of coverslip?

Hanging drop method

MICROSCOPIC EXAMINATION

A

sample volume: 10 uL
coverslip size: 22x22 (concave)

66
Q

SPERM MOTILITY: 2 detection methods

Afer addition of samples, sample should be allowed to stand for how many minutes?

Hanging drop method

MICROSCOPIC EXAMINATION

A

1 minute

67
Q

SPERM MOTILITY: 2 detection methods

Specimens detected through hanging drop method should be observed in how many high power fields?

Hanging drop method

MICROSCOPIC EXAMINATION

A

in 20 high power fields

68
Q

SPERM MOTILITY: 2 detection methods

Normal % of motile sperm cells within 1hour?

Hanging drop method

MICROSCOPIC EXAMINATION

A

> 50% within 1 hour

69
Q

SPERM MOTILITY: 2 detection methods

Identify Grade based on WHO criteria and Sperm motility

WHO Criteria: a
Sperm Motility: Rapid, straight line motility

Criteria for Hanging drop method

MICROSCOPIC EXAMINATION

A

4.0

70
Q

SPERM MOTILITY: 2 detection methods

Identify Grade based on WHO criteria and Sperm motility

WHO Criteria: b
Sperm Motility: Slower speed, some lateral movement

Criteria for Hanging drop method

MICROSCOPIC EXAMINATION

A

3.0

71
Q

SPERM MOTILITY: 2 detection methods

Identify Grade based on WHO criteria and Sperm motility

WHO Criteria: b
Sperm Motility: Slow forward progression, noticeable lateral movement

Criteria for Hanging drop method

MICROSCOPIC EXAMINATION

A

2.0

72
Q

SPERM MOTILITY: 2 detection methods

Identify Grade based on WHO criteria and Sperm motility

WHO Criteria: c
Sperm Motility: No forward progression

Criteria for Hanging drop method

MICROSCOPIC EXAMINATION

A

1.0

73
Q

SPERM MOTILITY: 2 detection methods

Identify Grade based on WHO criteria and Sperm motility

WHO Criteria: d
Sperm Motility: No movement

Criteria for Hanging drop method

MICROSCOPIC EXAMINATION

A

0

74
Q

SPERM MOTILITY: 2 detection methods

Give interpretation based on result of sperm motility:

> 50% within 1 hour

Sperm Motility Interpretation hanging drop

MICROSCOPIC EXAMINATION

A

Normal

75
Q

SPERM MOTILITY: 2 detection methods

Give interpretation based on result of sperm motility:

Motile in categories a, b, and c

Sperm Motility Interpretation hanging drop

MICROSCOPIC EXAMINATION

A

50% or more

76
Q

SPERM MOTILITY: 2 detection methods

Give interpretation based on result of sperm motility:

show progressive motility (a and b)

Sperm Motility Interpretation Hanging drop

MICROSCOPIC EXAMINATION

A

25% or more

77
Q

SPERM MOTILITY: 2 detection methods

T or F

One should observe immobile sperm and cliumps or antibodies when using hanging drop method

Sperm Motility Interpretation Hanging drop

MICROSCOPIC EXAMINATION

A

T

78
Q

SPERM MOTILITY: 2 detection methods

If there is high percentage of immobile sperm, what test could be performed?

Sperm Motility Interpretation Hanging drop

MICROSCOPIC EXAMINATION

A

Sperm
vitality testing

79
Q

SPERM MOTILITY: 2 detection methods

Clumping of sperm indicates possible presence of?

Sperm Motility Interpretation Hanging drop

MICROSCOPIC EXAMINATION

A

Sperm
agglutinins

80
Q

SPERM MOTILITY: 2 detection methods

Progressive motility, Nonprogressive motility, Immotility?

Sperm moving linearly or in large circle

Alternative Sperm Grading Criteria OF Hanging drop

MICROSCOPIC EXAMINATION

A

Progressive motility

PM

81
Q

SPERM MOTILITY: 2 detection methods

Progressive motility, Nonprogressive motility, Immotility?

Sperm moving in an absence of progression

Alternative Sperm Grading Criteria OF Hanging drop

MICROSCOPIC EXAMINATION

A

Nonprogressive motility

NP

82
Q

SPERM MOTILITY: 2 detection methods

Progressive motility, Nonprogressive motility, Immotility?

No movement

Alternative Sperm Grading Criteria OF Hanging drop

MICROSCOPIC EXAMINATION

A

Immotility

IM

83
Q

SPERM MOTILITY: 2 detection methods

Motility must be specified as?

Hanging drop

MICROSCOPIC EXAMINATION

A

Total Motility (PM and NP) or Progressive Motility (PM)

84
Q

SPERM MOTILITY: 2 detection methods

Familiarize the parameters detected by Computer-Assisted Semen Analysis (CASA)

Hanging drop

MICROSCOPIC EXAMINATION

A
  • Sperm velocity and trajectory – direction of motion
  • Sperm concentration
  • Sperm morphology
85
Q

SPERM MOTILITY: 2 detection methods

  • Performed using Bloom’s Test or Eosin/Nigrosin Test
  • Done in cases of infertility where the sperm count is normal but has decreased motility
  • Evaluate 100 sperm cells
A

Sperm vitality (viability)

86
Q

SPERM MOTILITY: 2 detection methods

T or F

Sperm vitality or viability is perfromed in cases of infertility where sperm count is abnormal and have decreased motility

SPERM VITALITY (VIABILITY)

MICROSCOPIC EXAMINATION

A

F (NORMAL sperm count, but decreased motility)

87
Q

SPERM MOTILITY: 2 detection methods

Interpret based on description of appearance:
* Not infiltrated by eosin
* Remain bluish white in color

SPERM VITALITY (VIABILITY)

MICROSCOPIC EXAMINATION

A

Living sperm cells

88
Q

SPERM MOTILITY: 2 detection methods

Interpret based on description of appearance:

Red (stained by eosin)

SPERM VITALITY (VIABILITY)

MICROSCOPIC EXAMINATION

A

Dead sperm

SPERM VITALITY (VIABILITY)

89
Q

SPERM MOTILITY: 2 detection methods

Interpret based on description of appearance:

Defective flagellum

SPERM VITALITY (VIABILITY)

MICROSCOPIC EXAMINATION

A

High number of vital but
immobile cells

90
Q

SPERM MOTILITY: 2 detection methods

Interpret based on description of appearance:

Epididymal pathology

SPERM VITALITY (VIABILITY)

MICROSCOPIC EXAMINATION

A

High number of immotile
and nonviable cells

91
Q

Sperm Morphology

Observe for head and tail morphology under what objective?

MICROSCOPIC EXAMINATION

A

Oil Immersion
Objective (OIO)

92
Q

Sperm Morphology

How many sperms are evaluated?

MICROSCOPIC EXAMINATION

A

200 sperms

93
Q

Sperm Morphology

T or F

In sperm morphology, one should take not of normal and abnormal forms

MICROSCOPIC EXAMINATION

A

T

94
Q

Sperm Morphology

(3) stains used in sperm morphology?

MICROSCOPIC EXAMINATION

A
  • Papanicolaou
  • Giemsa
  • Hematoxylin

PGH

95
Q

Sperm Morphology: Preparation of normal semen smear

angle of slide when dragging spcimen?

MICROSCOPIC EXAMINATION

A

45 degrees

96
Q

Sperm Morphology

What are the (3) distinct parts?

MICROSCOPIC EXAMINATION

A
  1. Head
  2. Middle piece
  3. Tail
97
Q

Sperm Morphology

  • For ovum penetration
  • Oval shaped head approximately 5 µm long and 3 µm wide
  • Acrosomal cap: approximately (40-70%) ½

(3) distinct parts

MICROSCOPIC EXAMINATION

A

Head

98
Q

Sperm Morphology

T or F

Head is 3 um long and 5 um wide

(3) distinct parts

MICROSCOPIC EXAMINATION

A

F (head is 5 um long, 3um wide)

99
Q

Sperm Morphology

Acrosomal cap occupies how big of the head?

(3) distinct parts

MICROSCOPIC EXAMINATION

A

½
of head (40-70%)

100
Q

Sperm Morphology

  • 7 um
  • Contains mitochondria that provide energy for flagellar tail motion

(3) distinct parts

MICROSCOPIC EXAMINATION

A

Middle piece

101
Q

Sperm Morphology

  • For motility
  • 40- 45 µm long

(3) distinct parts

MICROSCOPIC EXAMINATION

A

Tail

102
Q

Sperm Morphology

Head or Tail abnormalities?

will result to poor ovum penetration

Abnormalities

MICROSCOPIC EXAMINATION

A

Head abnormalities

103
Q

Sperm Morphology

Head or Tail abnormalities?

affect motility of the sperm

Abnormalities

MICROSCOPIC EXAMINATION

A

Tail abnormalities

104
Q

Sperm Morphology

This abnormality causes the sperm head to bend backward and interfere with motility

Abnormalities

MICROSCOPIC EXAMINATION

A

Abnormally long neckpiece

105
Q

Sperm Morphology

What are the (3) methods used for analysis of sperm morphology

A
  • Kruger’s-strict criteria
  • Computer-assisted semen analysis (CASA)
  • SQA-V Sperm quality analyzer
106
Q

Sperm Morphology

  • Recommended by WHO but not routinely performed
  • A system of evaluating sperm morphology using morphometry and stage micrometer
  • Strictly measures the head, neck, tail, acrosomal head and
    vacuoles
  • Normal forms (strict criteria): 14%
  • Normal forms (routine criteria): 30%

(3) methods used for analysis of sperm morphology

MICROSCOPIC EXAMINATION

A

Kruger’s-strict criteria

107
Q

Sperm Morphology

Tests for:
* Sperm velocity and trajectory (direction of motion)
* Sperm concentration
* Sperm morphology

(3) methods used for analysis of sperm morphology

MICROSCOPIC EXAMINATION

A

COMPUTER-ASSISTED SEMEN ANALYSIS (CASA)

108
Q

Sperm Morphology

  • Automatic results in 75 seconds
  • Measures Motility (PM+NP)
  • Immotility (IM)
  • % Normal Morphology
  • Average velocity (VELOCITY)
  • Sperm Motility Index (SMI)
  • Total sperm concentration (TSC)
  • Motile sperm concentration (MSC)
  • Progressively motile sperm
    concentration (PMSC)

(3) methods used for analysis of sperm morphology

MICROSCOPIC EXAMINATION

A

SQA-V SPERM QUALITY ANALYZER

AUBF (34 decks)

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