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CLINICAL MICROSCOPY > Semen > Flashcards

Semen Flashcards

1
Q

Reasons for semen analysis

A

Fertility testing
Post-vasectomy semen analysis
Forensic analyses

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2
Q

Semen is composed of four fractions that are contributed by

A

Testes and epididymis
Seminal vesicles
Prostate gland
Bulbourethral glands

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3
Q

Semen Composition

A

Spermatozoa 5%
Seminal fluid 60% to 70%
Prostate fluid 20% to 30%
Bulbourethral glands 5%

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4
Q

The stages of cellular maturation of sperm from youngest to most mature stage are as follows

A

Spermatogonia → Spermatocytes → Spermatids → Spermatozoa

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5
Q

Function of seminiferous tubule

A

Produce spermatozoa

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6
Q

Provide support and nutrients for the germ cells as they undergo mitosis and meiosis (spermatogenesis)

A

Sertoli cells

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7
Q

Duration of sperm maturation and development of flagella

A

90 days

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8
Q

Function of epididymis

A

Sperm maturation

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9
Q

The ejaculatory ducts receive both the sperm from the ductus deferens and fluid from the seminal vesicles. True or False?

A

True

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10
Q

Produce fluid to serve as the transport medium for the sperm

A

Seminal vesicles

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11
Q

Fluid that serves as the transport medium for the sperm

A

Semen

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12
Q

Seminal fluid contains a high concentration of

A

Fructose
Flavin

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13
Q

Function of fructose in semen

A

Spermatozoa metabolize the fructose for the energy needed for the flagella to propel them through the female reproductive tract

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14
Q

In the absence of fructose, sperm still display motility in the semen analysis. True or False?

A

False; do not display motility

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15
Q

Responsible for the gray appearance of semen

A

Flavin

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16
Q

Proteins secreted by seminal vesicles are involved in the coagulation of the ejaculate. True or False?

A

True

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17
Q

Aids in propelling the sperm through the urethra by contractions during ejaculation

A

Prostate gland

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18
Q

Milky acidic fluid that contains high concentrations of acid phosphatase, citric acid, zinc, and proteolytic enzymes

A

Prostatic fluid

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19
Q

Responsible for both the coagulation and liquefaction of the semen following ejaculation

A

Acid phosphatase, citric acid, zinc, and proteolytic enzymes in prostatic fluid

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20
Q

Produce a thick, alkaline mucus that helps to neutralize acidity from the prostate secretions and the vagina

A

Bulbourethral glands

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21
Q

Why is it important for semen to be alkaline?

A

To neutralize the vaginal acidity

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22
Q

The muscle movement causing the release of sperm and other seminal fluids

A

Peristalsis

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23
Q

Most of the sperm are contained in the first portion of the ejaculate. True or False?

A

True

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24
Q

Specimens are collected following a period of sexual abstinence of at least

A

2 days to not more than 7 days

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25
Q

Prolonged abstinence will result to

A

Higher volumes and decreased motility

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26
Q

How to collect samples for fertility test, as recommended by WHO

A

2-3 samples are collected not less than 7 days or more than 3 weeks apart, with 2 abnormal samples considered significant

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27
Q

Temperature requirement for specimen collected at home

A

Room Temperature

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28
Q

Specimen collected at home should be delivered to the laboratory within

A

1 hour of collection

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29
Q

Specimens awaiting analysis should be kept at temperature of

A

37 C

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30
Q

Clotted specimen should liquefy in

A

30-60 minutes

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31
Q

What to do if after 2 hours if the specimen has not liquefied?

A

Add Dulbecco’s phosphate-buffered saline, alpha-chymotrypsin, or bromelain to induce liquefaction

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32
Q

What will happen if the first portion of ejaculate missing?

A

Decreased sperm count, Falsely increased pH, Specimen will not liquefy

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33
Q

What will happen if the last portion of ejaculate missing?

A

Increased sperm count, Falsely decreased pH, Specimen will not clot, Decrease semen volume

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34
Q

Best method of semen collection

A

Self-production or masturbation

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35
Q

Enumerate and define the other methods of semen collection

A

Coitus interruptus: withdrawal method

Vaginal vault aspiration: aspiration of seminal fluid from the vaginal vault after coitus

Condom method: only nonlubricant-containing rubber or polyurethane condoms should be used

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36
Q

Why is it that coitus interruptus is not a reliable means of semen collection?

A

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

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37
Q

Why is it that ordinary condoms are not acceptable for semen collection?

A

They contain spermicides

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38
Q

Characteristic of normal semen

A

Gray-white color, translucent, and has a characteristic musty odor

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39
Q

Indication of clear semen

A

Sperm concentration is very low

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40
Q

White turbidity in semen indicates

A

Presence of WBCs and infection within the reproductive tract

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41
Q

Red coloration in semen indicates

A

Presence of RBCs and are abnormal

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42
Q

Yellow coloration in semen indicates

A

Urine contamination, specimen collection following prolonged abstinence, and medications

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43
Q

Failure of semen to liquefy within 60 minutes may be indicate a

A

Deficiency in prostatic enzymes

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44
Q

Normal semen volume

A

2-5 mL

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45
Q

Increased semen volume indicates

A

Extended abstinence

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46
Q

Decreased semen volume indicates

A

Infertility
Improper functioning of one of the semen producing organs
Incomplete specimen collection

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47
Q

Normal viscosity of semen

A

Easily drawn into a pipette and form small discrete droplets that do not appear clumped or stringy when falling by gravity from the pipette

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48
Q

Increased viscosity of semen

A

Droplets that form threads longer than 2 cm

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49
Q

The pH should be measured within

A

1 hour of ejaculation

50
Q

Normal semen pH

51
Q

Increased semen pH indicates

A

Infection within the reproductive tract

52
Q

Decreased semen pH indicates

A

Increased prostatic fluid, ejaculatory duct obstruction, or poorly developed seminal vesicles

53
Q

Reference value for sperm concentration

A

> 20-250 million sperm/mL

54
Q

Borderline value for sperm concentration

A

10 and 20 million sperm/mL

55
Q

Diluent used for sperm counting

A

Formalin
Sodium bicarbonate
Saline
Distilled water

56
Q

Purpose of diluents

A

To immobilize the sperm before counting

57
Q

Microscopy technique used for sperm counting

A

Phase or Bright-field microscopy

58
Q

Counting chamber used for undiluted specimen

A

Makler Counting Chamber

59
Q

Makler Counting Chamber uses _____ to immobilize sperm cells

60
Q

Mature sperm and WBCs, often referred to as “round” cells, must be included to the count. True or False?

A

False; must not be counted

61
Q

Formula for round cells

A

C = (Number of Round Cells x Sperm Concentration)/100

62
Q

> 1 million leukocytes/mL indicates

A

Inflammation or infection of the reproductive organs

63
Q

> 1 million spermatids/mL indicates

A

Disruption of spermatogenesis

64
Q

Normal value for sperm count

A

> 40 million/ejaculate

65
Q

Formula for sperm count

A

Sperm count = Sperm concentration x Volume of specimen

66
Q

Complete or total absence of spermatozoa

A

Azoospermia

67
Q

Complete or total absence of spermatozoa

A

Azoospermia

68
Q

Ejaculation does not emit any semen

69
Q

<10 million sperm/mL of semen

A

Oligospermia

70
Q

Nonviable or completely dead or immobile sperm

A

Necrospermia

71
Q

Motility that is critical for fertility

A

Forward, progressive movement

72
Q

Normal sperm motility

A

50%; rated as 2

73
Q

Sperm motility should be assessed using a _____ semen specimen within _____ of specimen collection; can be evaluated at _____

A

Well-mixed, liquefied
1 hour
Room temperature or 37°C

74
Q

Motility is evaluated by both

A

Speed
Direction

75
Q

Parameters measured by CASA

A

Velocity
Trajectory
Concentration
Morphology

76
Q

Transcribe CASA

A

Computer Assisted Semen Analysis

77
Q

Describe the WHO criteria for sperm motility

A

a Rapid, straight-line motility

b Slower speed, some lateral movement

b Slow forward progression, noticeable lateral movement

c No forward progression

d No movement

78
Q

Describe the alternative grading criteria for sperm motility

A

Progressive motility (PM) Sperm moving linearly or in a large circle

Nonprogressive motility (NP) Sperm moving with an absence of progression

Immotility (IM) No movement

79
Q

Percentage of sperm showing actual forward movement can then be estimated after evaluating approximately ______

80
Q

Characteristics of normal sperm head

A

Oval-shaped head approximately 5 µm long and 3 µm wide

81
Q

Length of flagellar tail

A

45 µm long

82
Q

Contains enzyme critical to ovum penetration

A

Acrosomal cap

83
Q

Attaches the head to the tail and the midpiece

84
Q

Thickest part of the sperm tail

85
Q

Length of midpiece

A

7.0 µm long

86
Q

Structure surrounding the midpiece

A

Mitochondrial sheath

87
Q

Abnormalities in head morphology leads to

A

Poor ovum penetration

88
Q

Neckpiece, midpiece, tail abnormalities affects

89
Q

Abnormally long neckpiece leads to

A

Sperm head to bend backward and interfere with motility

90
Q

Describe the routine criteria for sperm morphology

A

Sperm morphology is evaluated from a thinly smeared, stained slide under oil immersion

Staining can be performed using Wright’s stain, Giemsa, Shorr or Papanicolaou stain and is a matter of laboratory preference

At least 200 sperms should be evaluated and the percentage of abnormal sperm reported

Normal values: >30% normal forms

91
Q

Describe the krugger’s strict criteria for sperm morphology

A

Evaluating sperm morphology include measuring head, neck and tail size; measuring acrosome size and evaluating for the presence of vacuoles

Strict criteria evaluation requires the use of stage micrometer or morphometry

Strict criteria evaluation is an integral part of assisted reproduction evaluations

Normal values: >14% normal forms

92
Q

Decreased sperm vitality may be suspected when a specimen has a normal sperm concentration with markedly decreased motility. True or False?

93
Q

Sperm vitality should be assessed within

A

1 hour of ejaculation

94
Q

Vitality is evaluated by mixing the specimen with an eosin-nigrosin stain, preparing a smear, and counting the number of dead cells in 100 sperm using a brightfield or phase-contrast microscope

A

Modified Bloom’s Test

95
Q

Describe the result of Modified Bloom’s Test

A

Living cells: unstained and remain bluish white (at least 50%)

Dead cells: stain red against the purple background

96
Q

Presence of a large proportion of vital but immobile cells indicates

A

Defective flagellum

97
Q

High number of immotile and nonviable cells indicates

A

Epididymal pathology

98
Q

Normal quantitative level of fructose

A

≥13 µmol/ejaculate

99
Q

Screening test for the presence of fructose

A

Resorcinol Test

100
Q

Positive result of Resorcinol Test

A

Orange color

101
Q

Separates sperm from the male immune system

A

Blood-testes barrier

102
Q

Damaged sperm may cause the production of antibodies in the female partner. True or False?

103
Q

How to demonstrate antisperm antibodies in women?

A

Mix the semen with the female cervical mucosa or serum and observe for agglutination

104
Q

Screening procedure to detect the presence of immunoglobulin G (IgG) antibodies

A

Mixed agglutination reaction

105
Q

Describe the process of Mixed agglutination reaction

A

Semen sample containing motile sperm is incubated with IgG antihuman globulin (AHG) and a suspension of latex particles or treated RBCs coated with IgG

The bivalent AHG binds simultaneously to both the antibody on the sperm and the antibody on the latex particles or RBCs, forming microscopically visible clumps of sperm and particles or cells

106
Q

Normal value for mixed agglutination reaction

A

<10% motile sperm attached to the particles

107
Q

Specific procedure used to detect the presence of IgG, IgM, and IgA antibodies

A

Immunobead Test

108
Q

Immunobead Test demonstrates what area of the sperm the autoantibodies are affecting. True or False?

109
Q

Normal value of Immunobead Test

A

Presence of beads on <50% of the sperm

110
Q

The presence of >1 million leukocytes/mL indicates

A

Infection within the reproductive system, frequently the prostate

111
Q

Used to determine whether semen is actually present in a specimen in cases of alleged rape

A

Medico-legal testing

112
Q

Motile sperm can be detected for up to _____ after intercourse, whereas nonmotile sperm can persist for _____. As the sperm die off, only the heads remain and may be present for _____ after intercourse

A

24 hours
3 days
7 days

113
Q

A more specific method for sperm detection

A

Detection of seminal glycoprotein p30

114
Q

Positive result of Florence Test

A

Dark brown rhombic crystals

115
Q

Positive result of Barbiero’s Test

A

Yellow leaf-shape crystals

116
Q

Only concern is the presence or absence of spermatozoa

A

Postvasectomy semen analysis

117
Q

A single “motile” sperm on a wet preparation for postvasectomy analysis indicates

A

Unsuccessful vasectomy

118
Q

Sperm are incubated with species-nonspecific hamster eggs and penetration is observed microscopically

A

Hamster egg penetration

119
Q

Observation of sperm’s ability to penetrate partner’s midcycle cervical mucus

A

Cervical mucus penetration

120
Q

Sperm exposed to low-sodium concentrations are evaluated for membrane integrity and sperm viability

A

Hypo-osmotic swelling

121
Q

Evaluation of the acrosome to produce enzymes essential for ovum penetration

A

In vitro acrosome reaction

CLINICAL MICROSCOPY (20 decks)

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