FINALS - semenalysis Flashcards
what have resulted in increased emphasis on semen analysis.
Advances in the field of andrology
assisted reproductive technology (ART),
increased concern over fertility, particularly by couples choosing to have children later in life,
Patients with abnormal results on the routine semen analysis performed in the clinical laboratory are often referred to specialized andrology laboratories for further testing to determine the need for ___
in vitro fertilization (IVF)
In addition to fertility testing, the clinical laboratory performs ___ and ___ to
determine the presence of semen
post-vasectomy semen analysis
and
forensic analyses
The ___ are paired glands in the scrotum that contain
the seminiferous tubules for the secretion of sperm.
testes
The external location of the scrotum contributes to a __ scrotum
temperature that is optimal for sperm development
lower
germ cells for the production of spermatozoa are located in the ___ of the seminiferous tubules
epithelial cells
___ cells provide support and nutrients for the germ cells as they undergo mitosis and meiosis (spermatogenesis)
Specialized Sertoli
When spermatogenesis is complete, the immature sperm (nonmotile) enter the __
epididymis
In the epididymis, the sperm mature and develop ___.
flagella
The entire process of sperm maturation and development of flagella in epididymis takes approximately __days
90
The sperm remain stored in the __ until ejaculation
epididymis
The ejaculatory ducts receive both the sperm from the ___ and fluid from the ___
ductus deferens ; seminal vesicles
The ___ produce most of the fluid present in semen (60% to 70%)
seminal vesicles
this fluid is the transport medium for the sperm.
seminal fluid from seminal vesicle
Spermatozoa percent in semen
5%
seminal fluid percent in semen
60 - 70 %
prostate fluid percent in semen
20 - 30 %
bulbourethral gland percent in semen
5%
Spermatogenesis
Seminiferous Tubules of
Testes
Sperm Maturation
Epididymis
Propel the sperm to the
ejaculatory ducts
Ductus deferens
Provides nutrients for the
sperm and fluid
Seminal Vesicles
Provides enzymes and
proteins for coagulation
and liquefaction
Prostate Gland
Add alkaline mucus to
neutralize prostatic acid
and vaginal acidity
Bulbourethral glands
flow of semen to outside
Seminiferous tubules of the testes → Epididymis → Ductus deferens →
Ejaculatory Duct → Prostate Glands
Cut during vasectomy
Ductus Deferens
seminal vesicle provides __ and __
fructose and flavin
seminal vesicle Provides Fructose which is for
Nutrients and motility of the sperm
In the absence of __, sperm do not display motility in the semen analysis
fructose
seminal vesicle Provides flavin which is for __
Color of the sperm
The ___, located just below the bladder, surrounds the upper urethra and aids in propelling the
sperm through the urethra by contractions during ejaculation
muscular prostate gland
Approximately 20% to 30% of the semen volume is acidic fluid produced by the __
prostate gland.
The milky acidic fluid contains
high concentrations of __
acid phosphatase, citric acid, zinc, and
proteolytic enzymes
The milky acidic fluid contains
high concentrations of acid phosphatase, citric acid, zinc, and proteolytic enzymes
responsible for both the __ and ___ of the semen following ejaculation
coagulation and liquefaction
The __, located below the prostate,
bulbourethral glands
Various proteins secreted by the seminal
vesicles are involved in the coagulation of the ejaculate.
true or false
true
Protects the sperm from acidic conditions of the vagina
Bulbourethral Glands
bulbourethral gland, produces __ that helps to neutralize acidity from the
prostate secretions and the vagina
alkaline mucus
what will happen if the first portion of the ejaculate is missing
the sperm count will be decreased
the pH falsely increased,
the specimen will not liquefy
what will happen if the last portion of the ejaculate is missing
semen volume is decreased,
the sperm count is falsely increased,
the pH is falsely decreased,
and the specimen will not clot
A test specific for the prostate gland but not for prostate cancer
Prostate Gland Antigen
It is a protein produced by a normal, or by a malignant cell, by the
prostate gland
Prostate Gland Antigen
Prostate Gland Antigen is for the detection of
Hyperplasia and or hypertrophy
Importance of Seminalysis
to check for infertility
to check if the vasectomy or vasectomy reversal has been successful
provide information on:
o Sperm production
o Patency of the male ducts
o The function of the accessory glands
o Ejaculative function
___ is the SINGULAR test for fertility in male
Semen Analysis
Semen Analysis is the singular test for fertility in male that can
provide information on
o Sperm production
o Patency of the male ducts
o The function of the accessory glands
o Ejaculative function
do we Always ask the age of the patient when it comes to Semen Analysis?
yes
in specimen collection,
do we collect the Majority of the
sperm are contained in
the first portion
of the ejaculate
yes
Sexual
abstinence
from __ days
but no longer
than ____days
2-3; 5
not more than 7 days in the book
abstinence that is 5 (7) days results in
Higher volumes and
decreased motility
how many samples are needed for fertility testing
2-3 samples
how many weeks interval is needed for the fertility testing with 2-3 samples
2 weeks interval
not less than 7 days and more than 3 weeks apart
Specimen should be collected at __ temperature
room
Specimen should be kept
at room temperature and delivered to the
laboratory within ___ hour
1 hr
Kept at what temperature if
awaits analysis
37ºC
what type of condoms are used for collection
non lubricant or polyurethane
Ordinary Condoms are not allowed because it
is __
spermicidal
Ways of Semen Collection
Masturbation
Coitus Interruptus
Condom method
Assisted ejaculation
Directing the semen into a clean sample cup
Masturbation
Coitus Interruptus
Literal meaning;
Sex Interruption
With drawing the penis from the partner just before
ejaculating follow by ejaculating into a clean sample cup
Coitus Interruptus
why do coitus interrupts is not a reliable means of semen collection?
because the first portion of the ejaculate, which contains the highest number of spermatozoa, may be lost and the low pH of the vaginal fluid may affect sperm motility
Usage of nonlubricant containing rubber or polyurethane
condom
Condom method
Electro-ejaculation used in paraplegics
Assisted ejaculation
If the specimen collected is too solid
can we continue the test?
nope, we can’t continue in examining the
semen
should the Patient must urinate before collecting the semen?
yes
in Macroscopic/ Physical
Examination, what are the parameters we must take note
Parameters recorded:
Appearance/Color
Volume
Viscosity
Liquefaction
pH
in microscopic
Examination, what are the parameters we must take note
Parameters reported:
Motility
Viability
Sperm morphology
Sperm concentration and
count
Normal Color of semen
Gray-white, translucent, pearly white,
colorless to creamy white
Odor of semen
Musty or bleach or Chlorox Odor
Increased white turbidity in semen means
increased WBC or infection within the reproductive tract
in cases of white turbidity due to infection within the reproductive tract and a presence of increased wbc, If required,
specimen ___ is performed prior to continuing with the semen analysis
culturing
During microscopic examination, WBCs must
be differentiated from ___
immature sperm (spermatids)
The ___ reagent strip test may be useful to screen for the presence of WBCs.
leukocyte esterase
When the sperm concentration is very low, the specimen may appear almost ___
clear
Red Coloration in semen means
Increased RBC
Yellow Coloration in semen means
Increased contamination,
Urine contamination or medication
is urine toxic to sperms?
yep, it can affect evaluation of MOTILITY
Normal volume of semen
2-5 mL
semen Increased In
Abstinence
semen Decreased In
Infertility
Incomplete Collection
normal Viscosity
Pour in droplets
(Highly viscous)
Increased viscosity found in
Decreased sperm motility
Reporting of viscosity of semen
0 – Watery
4 – Gel like
Normal ph of semen
7.2 to 8.0
or 7.3 to
8.3
Increased pH
Infection
Decreased pH
Increased Prostatic fluid
Sperm concentration ref values
> 20 million/mL
Sperm count ref range
> 40 million/ejaculate
Motility ref range
> 50% within 1 h
Quality ref range
> 2.0 or a, b, c
Morphology ref range
> 14% normal forms (strict criteria)
30% normal forms (routine criteria)
Round cells ref range
<1.0 million/mL
Sperm Motility Grading
Grade A
These sperm have progressive motility; they are
the strongest and they swim fast in a straight line
A fresh semen specimen is clotted and should liquefy within ___ minutes after collection
30 to 60
since semen can liquify within 30-60 mns of collection, ___ is essential for evaluating semen liquefaction.
recording the time of collection
Failure of liquefaction to occur within 60 minutes may be caused
by a deficiency in __ and should be reported.
prostatic enzymes
Analysis of the specimen cannot begin until ___has occurred
liquefaction
If after 2 hours the specimen has not liquified, an equal volume of physiologic ___ or ___ may be added to induce liquefaction and allow the rest of the analysis to be performed.
Dulbecco’s phosphate-buffered saline or proteolytic enzymes such as alpha
chymotrypsin or bromelain
proteolytic enzymes such as ___
alpha
chymotrypsin or bromelain
the use of Dulbecco’s phosphate-buffered
saline and proteolytic enzymes may affect ___ so their use must be documented
biochemical tests, sperm motility, and sperm morphology,
___may be present in liquefied semen
specimens and have no clinical significance
Jelly-like granules (gelatinous bodies)
relationship of viscosity and liquefaction
incomplete liquefied semen are clumped and highly viscous.
___ the sample container during liquefaction can help produce a homogeneous sample
Gently mixing
Droplets that form threads longer than ___ cm are considered highly viscous
and are recorded as abnormal
2
. The pH should be measured within 1 hour
of ejaculation due to the loss of ____that occurs
CO2
2 ways we can measure sperm pH
reagent strip and litmus paper
Sperm Motility Grading
Grade B
These sperm with non-progressive motility teds to
travel in a curved or crooked motion
Sperm Motility Grading
Grade C
These sperm either move their tail or are immotile
Grade
4 - A who criteria
Rapid, Straight-line motility
Grade
3 - B who criteria
Slower speed, some lateral movement
Grade
2 - B who criteria
Slow forward progression, noticeable
lateral movement
Grade
1 - C who criteria
No forward progression
Grade
0 - D who criteria
No movement
Alternative sperm motility grading criteria
Progressive motility
(PM)
Nonprogressive motility
(NP)
Immotility (IM)
Alternative sperm motility grading criteria
Sperm moving linearly or in a large circle
Progressive motility
(PM)
Alternative sperm motility grading criteria
Sperm moving with an absence of
progression
Nonprogressive motility
(NP)
Alternative sperm motility grading criteria
No movement
Immotility (IM)
what have resulted in increased emphasis on semen analysis.
Advances in the field of andrology
assisted reproductive technology (ART),
increased concern over fertility, particularly by couples choosing to have children later in life,
what have resulted in increased emphasis on semen analysis.
Advances in the field of andrology
assisted reproductive technology (ART),
increased concern over fertility, particularly by couples choosing to have children later in life,
are we inlcuding spermatids and wbc in counting sperm concentration?>
no - referred as round cells
what does it mean for more than 1 million leukocytes in semen?
infection or inflammation in reproductive organ
what does it mean for more than 1 million spermatids in semen?
disruption in the spermatogenesis
ref range of sperm concentration
greater than 20-250 million/ml
how to determine total sperm count
multiply the sperm concentration by its volume
structure of sperm
head, neckpiece, midpiece, tail
head abnormality is related to what function
poor ovum penetration
neckpiece, midpiece, and tail abnormality is related to what function
motility
dimensions of the head of the sperm
5 um long , 3 um wide
how long is the midpiece
7 um long
how long is the flagellar tail
45 um
which part of the sperm is critical for ovum penetration
acrosomal cap that has enzymes
this part attaches the head to the midpiece and tail
neck piece
thickest part of the sperm
midpiece - has mitochondrial sheath
how many ml of semen is drop in the slide for microscopic examination
10 ul
stains used for microscopic examination of sperm
wright’s, giemsa, shorr, papanicolau
air dried slides are stable for how many hrs
24 hrs
atleast how many sperm is evaluated
200 - and report the percentage of abnormal sperm observed
what will happen in an abnormally long neckpiece
can cause the sperm to bend backward and interfere with motility
an additional parameter in evaluating sperm morphology such as measuring the head, neck, and tail size, as well as measuring the acrosome, and evaluating vacuoles is referred to as ____
kruger’s strict criteria
kruger’s strict criteria requires a use of stage such as __
micrometer or morphometry
decrease sperm vitality is suspected when there is a normal __ but decrease ___
normal concentration but decrease motility
ang relationship kasi ng concentration and motility is inversely, kapag too concentrated dapat mababa ang motility. In this case, normal lang si concentration pero bakit decrease ang motility, so diyan papasok si vitality
sperm vitality should be assessed within how many hr of ejaculation
1 hr
in morphology, 200 sperms are counted, how about in vitality?
100 sperms are counted and dead sperms are reportedw
what stain is used for vitality testing of sperm
eosin-nigrosin stain
describe the eosin-nigrosin stain in vitality testing in terms of its staining ability to living cells and dead sperms
living sperm will not be penetrated by the stain and remain bluish white while dead sperms will be stained red against purple background
normal vitality ref range
50% or greater living cells/sperms
if there’s high immotile but vital sperm, what does it mean
possible flagellar problem
if there’s high immotile and nonvital sperm, what does it mean
epididymal pathology or problem in epididymis
specimens can be screened for the presence of fructose using what test
resorcinol test that produces an orange color when fructose is present
ref range of fructose per ejaculate
13 umol per ejaculate
specimens for fructose levels are should be tested within how many hrs to prevent fructolysis
2 hrs or frozen it
two frequently used test to detect the presence of antibody coated sperm are
MAR - mixed agglutination reaxtion
and
immunobead
explain why immunobead is much more specific than the MAR test for antisperm antibodies
it can detect not only IgG, but also IgM, IgA, and the part of sperm that is affected
mycroorganism frequently encountered in microbial testting of sperm
chlamydia trachomatis
mycoplasma hominis
ureaplasma urealyticum
motile sperms can stay up to ___ hrs after intercourse
24 hrs
nonmotile sperms can stay up to ___ hrs after intercourse
3 days
as the sperm die off, what part of the sperm remains and may be present for 7 days
the heads
a more specific test to detect semen in a specimen is the detection of ___
seminal glycoprotein p30 (PSA) - present even in the absent of sperm in the specimen
sperm function test
sperm are incubated with species-nonspecif hamster eggs and penetration is observed microscopically
hamster egg penetration
sperm function test
observation of sperm’s ability to penetrate partner’s midcycle cervical mucus
cervical mucus penetration
sperm function test
sperm exposed to low-sodium concentrations evaluated for membrane integrity and sperm viability
hypo-osmotic swelling
sperm function test
evaluation of the acrosome to produce enzymes essential for ovum penetration
in vitro acrosome reaction
