SEMEN Flashcards
1
Q
The study of diseases of the male reproductive organs
A
Andrology
2
Q
What are the four fractions that comprise semen?
A
- Spermatozoa
- Seminal fluid
- Prostate fluid
- Liquid contributed by the bulbourethral glands
3
Q
Major fraction of semen
A
Seminal fluid (60%-70%)
4
Q
Identify percentage of semen composition: SPERMATOZOA
A
5%
5
Q
Identify percentage of semen composition: SEMINAL FLUID
A
60%-70%
6
Q
Identify percentage of semen composition: PROSTATE FLUID
A
20%-30%
7
Q
Identify percentage of semen composition: BULBOURETHRAL GLANDS
A
5%
8
Q
These are paired glands in the scrotum that contain the seminiferous tubules for the secretion of sperm.
A
Testes
9
Q
(Higher/Lower) temperature is optimal for sperm development.
A
Lower
10
Q
There are cells also pertained to as primary spermatocytes located in the epithelial cells of the seminiferous tubules and are essential for the production of spermatozoa.
A
Germ cells
11
Q
These cells provide support and nutrients for the germ cells as they undergo mitosis and meiosis.
A
Specialized Sertoli cells
12
Q
The process of sperm development by means of both mitosis and meiosis is termed as ____________.
A
Spermatogenesis
13
Q
This is where sperm mature and develop flagella.
A
Epididymis
14
Q
TRUE or FALSE:
The entire process of sperm development takes approximately 90 days.
A
TRUE
NOTE:
The sperm remain stored in epididymis until ejaculation.
15
Q
Major components of seminal fluid
A
Fructose
Flavin
16
Q
This serves as the energy source of spermatozoa and is necessary for propelling of flagella.
A
Fructose
17
Q
TRUE or FALSE:
In the absence of fructose, sperm do not display motility in the semen analysis.
A
TRUE
18
Q
The gray appearance of semen is due to the presence of __________.
A
Flavin
19
Q
Approximately 20% - 30% of the semen volume is acidic fluid and is produced by which gland?
A
Prostate gland
20
Q
The prostate gland is located (below/above) the bladder.
A
BELOW
NOTE:
It surrounds the upper urethra and aids in propelling sperm through the urethra by contractions during ejaculation.
21
Q
The milky acidic fluid contains all of the following EXCEPT:
A. Acid phosphatase
B. Citric acid
C. Zinc
D. Proteolytic enzymes
E. None of the above
A
E. None of the above
NOTE: All are present in the milky, acidic fluid in high concentrations
22
Q
This is located below the prostate gland and produces alkaline mucus which helps neutralize vaginal acidity.
A
Bulbourethral gland
NOTE: The fluid contributed by the bulbourethral glands is important because without the neutralization, sperm motility will be diminished.
23
Q
TRUE or FALSE:
Most of the sperm are contained in the first portion of the ejaculate.
A
TRUE
NOTE: Without the first portion, sperm count will be decreased, pH falsely increased, and specimen will not liquefy.
24
Q
Period of sexual abstinence prior to specimen collection (semen)
A
2-7 days
25
TRUE or FALSE:
Specimens collected following prolonged abstinence tend to have higher volumes and increased motility.
FALSE
NOTE:
Specimens collected following prolonged abstinence tend to have higher volumes and DECREASED motility.
26
TRUE or FALSE:
According to WHO, fertility tests must include two or three samples collected not less than 7 days or more than three weeks apart.
TRUE
NOTE:
Two abnormal samples will be considered significant.
27
When the specimen (semen) has to be transported to the laboratory, it must be kept at what temperature?
Room temperature
28
TRUE or FALSE:
Upon receiving the specimen (semen), the laboratory personnel must record the patient’s name and birth date, period of sexual abstinence, completeness of sample, time of specimen collection, and even difficulties in collection.
TRUE
29
Specimens (semen) awaiting analysis should be kept at what temperature?
37°C
30
TRUE or FALSE:
In collecting semen, ordinary condoms may be used for collection if masturbation cannot be done.
FALSE
Only non-lubricant-containing rubber or polyurethane condoms should be used.
31
TRUE or FALSE:
Coitus interruptus is a recommended means of semen collection.
FALSE
Coitus interruptus is not reliable because the first portion of ejaculate with the highest concentration of sperm may be lost and motility may be affected due to low pH of vaginal fluid.
32
TRUE or FALSE:
Semen analysis for fertility evaluation consists of both macroscopic and microscopic examination.
TRUE
NOTE:
The following are evaluated:
* Appearance
* Volume
* Viscosity
* pH
* Sperm concentration and count
* Motility
* Morphology
33
Characteristic odor of semen
Musty
34
Normal semen has a gray-white color and appears (transparent/translucent/turbid).
Translucent
35
Increased white turbidity of semen indicates the presence of which type of cells?
White blood cells
36
During microscopic examination, white blood cells must be differentiated from immature sperm cells which are also known as __________.
Spermatids
37
Strip test that may be used to screen for the presence of white blood cells in the semen.
Leukocyte esterase reagent strip test
38
TRUE or FALSE:
Varying amounts of red coloration in the semen are associated with RBCs and are abnormal.
TRUE
39
TRUE or FALSE:
Urine is toxic to sperm.
TRUE
NOTE:
This can affect sperm’s motility.
40
What would be the color of the sperm associated with prolonged abstinence, urine contamination, or certain medications?
Yellowish
41
This part of the male reproductive system mainly helps in propelling sperm to ejaculatory ducts.
Ductus deferens
42
The part of the male reproductive system that provide nutrients for sperm and fluid.
Seminal vesicles
43
The part of the male reproductive system that provide enzymes and proteins for coagulation and liquefaction.
Prostate gland
44
The part of the male reproductive system that add alkaline mucus to neutralize prostatic acid and vaginal acidity
Bulbourethral glands
45
Normal semen volume
2-5 mL
46
Normal viscosity of semen
Pours in droplets
47
Normal semen pH
7.2-8.0
48
Normal sperm concentration
>20 million/mL
49
Normal sperm count
>40 million/ejaculate
50
Normal sperm motility
>50% within 1 hr
51
Normal sperm quality
>2.0
52
Normal sperm morphology (% of normal forms) according to strict criteria
>14% normal forms
53
Normal sperm morphology (% of normal forms) according to routine criteria
>30% normal forms
54
Normal round cell count in semen
<1.0 million/mL
55
A normal semen specimen must liquefy within _____________ after collection.
30-60 minutes
NOTE:
Failure of liquefaction to occur within 60 minutes may be caused by a deficiency of prostatic enzymes and should be reported.
56
TRUE or FALSE:
Analysis of specimen cannot begin until liquefaction has occurred.
TRUE
57
If after 2 hours the semen specimen has not yet liquefied, what may be added to induce liquefaction?
Physiologic Dulbecco’s phosphate-buffered saline or proteolytic enzymes (alpha-chymotrypsin or bromelain)
58
TRUE or FALSE:
Gelatinous bodies present in liquefied semen has no clinical significance.
TRUE
59
INCREASED or DECREASED semen volume:
Extended abstinence
INCREASED
60
INCREASED or DECREASED semen volume:
Infertility
DECREASED
61
TRUE or FALSE:
Incompletely liquefied specimens are clumped and highly viscous.
TRUE
62
In performing semen dilution with physiologic saline, this is added to prevent precipitation.
Calcium chloride dehydrated solution
63
In performing semen dilution with physiologic saline, this is added to adjust the pH to 7.4
Sodium hydroxide
64
Preparation of 10 IU/mL bromelain in Dulbecco’s phosphate-buffered saline (dissolving) takes _______ minutes.
15-20 minutes
65
Droplets that form threads longer than _____ cm are considered highly viscous and abnormal.
2
66
In reporting semen viscosity, this rating means the sample is gel-like.
4
NOTE:
Viscosity can also be reported as low, normal, or high
67
In reporting semen viscosity, this rating means the sample is watery.
0
68
Semen pH must be measured within _______ minutes.
60 (1 hr)
69
INCREASED or DECREASED semen pH:
Increased prostatic fluid
DECREASED
70
INCREASED or DECREASED semen pH:
Ejaculatory duct obstruction
DECREASED
71
INCREASED or DECREASED semen pH:
Infection within the reproductive tract
INCREASED
72
INCREASED or DECREASED semen pH:
Poorly developed seminal vesicles
DECREASED
73
Sperm concentration considered borderline.
10-20 million/mL
74
Common listing for sperm concentration.
>20-250 million sperm/mL
75
Total sperm count formula:
(sperm concentration x specimen volume)
76
This tool is used to perform sperm concentration
Neubauer counting chamber
77
The most commonly used dilution in performing sperm count
1:20
78
TRUE or FALSE:
Sperm count may be performed on diluted and undiluted specimens.
FALSE
NOTE:
Dilution of semen is essential to immobilize sperm before counting.
79
Components of traditional diluting fluid used to immobilize sperm
Sodium bicarbonate
Formalin
80
If sodium bicarbonate and formalin are not available as diluting fluid, this can be also used to produce good results.
Saline
Distilled water
81
What parts of the Neubauer counting chamber are sperm counted?
Four corner and center squares of the large center square
NOTE:
This is similar to performing RBC count
82
How long must the sperm be settled in the hemocytometer prior to actual counting?
3-5 minutes
83
The sperm count on both sides of the hemocytometer must agree within ____%.
10
NOTE:
If the counts do not agree, dilution and counts are repeated.
84
This stain is added to aid in sperm visualization when using bright-field microscopy.
Crystal violet
85
Immature sperms and white blood cells are termed as ________.
Round cells
86
TRUE or FALSE:
In sperm count, fully developed sperm and round cells are all included in the count.
FALSE
NOTE:
Only fully developed sperm are counted. Round cells are not included in the count, but are significant and may need to be counted separately.
87
A WBC count of ___________ in semen is associated with infection of inflammation.
>1 million leukocytes/mL
88
A spermatid count of ____________ indicates disruption of spermatogenesis.
>1 million spermatids/mL
NOTE: This may be caused by viral infections, exposure to toxic chemicals, and genetic disorders.
89
In the calculation of sperm concentration using 1:20 dilution and five RBC squares in the large center square, the number of sperm is multiplied by _______ to equal the sperm concentration/mL.
1,000,000
90
TRUE or FALSE:
The presence of sperm capable of forward, progressive movement is critical for fertility.
TRUE
91
TRUE or FALSE:
The practice of examining sperm motility at timed intervals over an extended period is a useful procedure.
FALSE
NOTE:
This method has been shown to serve no useful purpose.
92
In evaluating sperm motility, how many high-power fields must be observed?
20 high-power fields
93
Sperm motility is evaluated according to which two parameters?
Speed
Direction
94
SPERM MOTILITY GRADING:
Rapid, straight-line motility
4.0
95
SPERM MOTILITY GRADING:
Slower speed, some lateral movement
3.0
96
SPERM MOTILITY GRADING:
Slow forward progression, noticeable lateral movement
2.0
97
SPERM MOTILITY GRADING:
No forward progression
1.0
98
SPERM MOTILITY GRADING:
No movement
0
99
SPERM MOTILITY ACCORDING TO WHO CRITERIA:
Rapid, straight-line motility
a
100
SPERM MOTILITY ACCORDING TO WHO CRITERIA:
Slower speed, some lateral
movement
b
101
SPERM MOTILITY ACCORDING TO WHO CRITERIA:
Slow forward progression,
noticeable lateral movement
b
102
SPERM MOTILITY ACCORDING TO WHO CRITERIA:
No forward progression
c
103
SPERM MOTILITY ACCORDING TO WHO CRITERIA:
No movement
d
104
TRUE or FALSE:
A minimum motility of 50% with a rating of 2.0 after 1 hour is considered normal.
TRUE
105
TRUE or FALSE:
In evaluating the sperm motility particularly via WHO rating of a, b, c, and d, if 50% or more of sperm are motile in categories a, b, and c, or 25% or more of sperm show progressive motility (a and b) within 1 hour, the motility is normal.
TRUE
106
An alternative sperm motility grading criteria according to WHO Laboratory Manual for the Examination and Processing of Human Semen (2010) can either be ________, _________, or _________.
* Progressive Motility
* Nonprogressive motility
* Immotility (IM)
107
An alternative sperm motility grading which describes sperm moving linearly or in a large circle.
Progressive Motility (PM)
108
An alternative sperm motility grading which describes sperm moving with an absence of progression.
Nonprogressive motility
109
An alternative sperm motility grading which describes sperm having no movement.
Immotility
110
This is an instrumentation that provides objective determination of both sperm velocity and trajectory. This also includes sperm concentration and morphology.
Computer-assisted semen analysis (CASA)
111
TRUE or FALSE:
Abnormalities in tail morphology are associated with poor ovum penetration.
FALSE
NOTE:
* Abnormality in head morphology = poor ovum penetration
* Abnormality in tail morphology = Motility problems
112
Normal length of flagellar tail
45 um
113
Normal length and width of sperm head
5 um long, 3 um wide
114
Specific part of the head of the sperm which is critical to ovum penetration.
Acrosomal cap (located at the tip of the head)
115
The acrosomal cap must encompass approximately half of the head and cover what part (in fraction) of sperm nucleus?
2/3
116
This part of the sperm attaches the head to the tail and the midpiece
Neckpiece
117
Normal length of midpiece
7.0 um
NOTE:
This is also the thickest part of the tail because it is surrounded by a mitochondrial sheath that produces the energy required by the tail for motility.
118
TRUE or FALSE:
Sperm motility can be evaluated at room temp or 37°C.
TRUE
119
TRUE or FALSE:
In assessing sperm motility, it is important that the slides and cover slips are prewarmed.
TRUE
120
Air-dried slides containing semen samples are stable for how many hours?
24 hours
121
TRUE or FALSE:
An abnormally long neckpiece has no significant effect to sperm motility.
FALSE
NOTE:
An abnormally long neckpiece may cause the sperm head to bend backward and interfere with motility.
122
This is a method used to evaluate sperm morphology which includes measuring head, neck, and tail size, measuring acrosome size, and evaluating for the presence of vacuoles.
Kruger’s strict criteria
123
These are the predominant form of leukocyte in semen.
Peroxidase-positive granulocytes
NOTE:
This can be differentiated from spermatogenic cells and lymphocytes using peroxidase stain.
124
Calculation of round cells is done using what formula?
C = (N x S) / 100
* N = number of spermatids or neutrophils counted per 100 mature sperm
* S = sperm concentration in millions/mL
125
If sperm abnormalities are discovered in routine parameters, additional testing may be requested. These tests include:
* Sperm vitality
* Seminal fluid fructose level
* Sperm agglutinins
* Microbial infection
126
Identify the POSSIBLE ABNORMALITY given the following abnormal result:
Decreased motility with normal count
Vitality
127
Identify the POSSIBLE ABNORMALITY given the following abnormal result:
Decreased count
Lack of seminal vesicle support medium
128
Identify the POSSIBLE ABNORMALITY given the following abnormal result:
Decreased motility with clumping
Male anti-sperm antibodies
129
Identify the POSSIBLE ABNORMALITY given the following abnormal result:
Normal analysis with continued infertility
Female anti-sperm antibodies
130
Identify the POSSIBLE NORMALITY addressed by the following test:
Eosin-nigrosin stain
Vitality
131
Identify the POSSIBLE NORMALITY addressed by the following test:
Fructose level
Lack of seminal support medium
132
Identify the POSSIBLE NORMALITY addressed by the following test:
Mixed agglutination reaction and immunobead tests
Male anti-sperm antibodies
133
Identify the POSSIBLE NORMALITY addressed by the following test:
Sperm agglutination with female serum
Female anti-sperm antibodies
134
Identify the POSSIBLE NORMALITY addressed by the following test:
Sperm agglutination with male serum
Male anti-sperm antibodies
135
Identify which TEST/S can be used to address the following sperm abnormalities:
Vitality
Eosin-nigrosin stain
136
Identify which TEST/S can be used to address the following sperm abnormalities:
Lack of seminal vesicle supporting medium
Fructose level
137
Identify which TEST/S can be used to address the following sperm abnormalities:
Male anti-sperm antibodies
* Mixed agglutination reaction and immunobead tests
* Sperm agglutination with male serum
138
Identify which TEST/S can be used to address the following sperm abnormalities:
Female anti-sperm antibodies
Sperm agglutination with female serum
139
Sperm vitality should be assessed within _____ hour of ejaculation.
1 hour
140
In evaluating sperm vitality, the number of dead cells are counted in how many sperm?
100
NOTE:
This uses bright-field or phase-contrast microscopy
141
What color are the living cells when using the eosin-nigrosin stain to evaluate sperm vitality?
Bluish white
NOTE:
Living cells are not infiltrated by the dye
142
What color are the dead cells when using the eosin-nigrosin stain to evaluate sperm vitality?
Red against a purple background
143
Normal vitality requires _____% or more living cells.
50%
144
Presence of a large proportion of vital but immobile cells indicate problems with which part of the sperm?
Flagellum
145
High number of immotile and nonviable sperm cells may indicate problems with what part of the male reproductive system?
Epididymis
146
This is a test used to screen for the presence of fructose in semen which produces an orange or orange-red color when fructose is present.
Resorcinol test
147
Normal fructose level
≥ 13 umol/ejaculate
148
Semen specimens to be tested for fructose levels must be examined within _____ hour/s of collection.
2 hours
149
When semen cannot be tested for fructose levels yet, what is the storage condition required?
A. Frozen
B. Room temperature
C. Refrigerated
A. Frozen
NOTE:
This is to prevent fructolysis.
150
TRUE or FALSE:
Antisperm antibodies can be present in both men and women.
TRUE
NOTE:
These may be detected in semen, cervical mucosa, or serum. Male antisperm antibodies are also more frequently encountered than female antisperm antibodies.
151
Under normal conditions, this separates sperm from the male immune system.
Blood-testes barrier
152
The procedure used to reverse vasectomy.
Vasovasostomy
153
TRUE or FALSE:
Presence of antibodies in a male subject can be suspected when clumps of sperm are observed during a routine semen analysis
TRUE
154
What is the mode of reporting of agglutination that occurs in anti-sperm antibodies?
“Few,” “Moderate,” “Many”
155
These are the two frequently used tests to detect the presence of antibody-coated sperm
* Mixed agglutination reaction (MAR) test
* Immunobead test
156
This is a screening procedure used primarily to detect the presence of IgG antibodies.
MAR test
157
In performance of MAR test, a finding of less than ____% of the motile sperm attached to the particles is considered normal.
10%
158
This test is a more specific procedure for detection of presence of antibody-coated sperm. This detects the presence of IgG, IgM, and IgA.
Immunobead test
159
TRUE or FALSE:
Immunobead test is also capable of demonstrating which area of the sperm the autoantibodies are affecting.
TRUE
160
What is added to the sperm in performing Immunobead test to detect antisperm antibodies?
Polyacrylamide beads coated with either anti-IgG, anti-IgM, or anti-IgA.
161
In performance of Immunobead test, the presence of beads on ______% of the sperm is considered normal (as defined by WHO).
<50%
162
Which organisms are frequently tested for when presence of more than 1 million leukocytes/mL is present in the semen.
Chlamydia trachomatis
Mycoplasma hominis
Ureaplasma urealyticum
163
Just as decreased fructose levels are associated with a lack of seminal fluid, decreased neutral α -glucosidase, glycerophosphocholine, and L-carnitine suggest a disorder of which part of the male reproductive system?
epididymis
164
(Increased/Decreased) zinc, citric acid, glutamyl transpeptidase, and acid phosphatase indicate a lack of prostatic fluid.
Decreased
165
In testing for the presence of semen (e.g., cases of alleged rape), the specimen may be enhanced using what reagent?
Xylene
166
How long can motile sperm be detected after intercourse?
24 hours
167
How long can nonmotile sperm be detected after intercourse?
3 days
168
When the sperm dies off, the heads remain and may be present for ______ days after intercourse.
7 days
169
This enzyme is useful in detecting presence of semen in specimen as this is present in high concentrations in seminal fluid.
Prostatic acid phosphatase
170
This antigen is a more specific method to detect presence of semen in a specimen as it is present despite absence of sperm.
Seminal glycoprotein p30 (Prostatic Specific Antigen)
171
Normal values of neutral a-glucosidase in semen
≥20 mU/ejaculate
172
Normal values of zinc in semen
≥2.4 umol/ejaculate
173
Normal values of citric acid in semen
≥52 umol/ejaculate
174
Normal values of acid phosphatase in semen
≥200 Units/ejaculate
175
In postvasectomy semen analysis, specimens are routinely tested at monthly intervals, beginning at how many months postvasectomy?
2
NOTE:
The testing continues until two consecutive monthly specimens show no spermatozoa.
176
In postvasectomy semen analysis, wet preparation detecting for the presence of motile and nonmotile sperm is done using ______ microscopy.
Phase
177
A negative wet preparation for postvasectomy semen analysis involves specimen centrifugation for ______ minutes and examination of the sediment.
10
178
TRUE or FALSE:
A single “motile” sperm on a wet preparation is an indication of an unsuccessful vasectomy.
TRUE
179
A sperm function test wherein sperm are incubated with species-nonspecific hamster eggs and penetration is observed microscopically.
Hamster egg penetration
180
A sperm function test involving observation of sperm’s ability to penetrate partner’s midcycle cervical mucus
Cervical mucus penetration
181
A sperm function test where sperm exposed to low-sodium concentrations are evaluated for membrane integrity and sperm viability
Hypo-osmotic swelling
182
A sperm function test involving evaluation of the acrosome to produce enzymes essential for ovum penetration
In vitro acrosome reaction
