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SEMEN Flashcards

1
Q

The study of diseases of the male reproductive organs

A

Andrology

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2
Q

What are the four fractions that comprise semen?

A
  • Spermatozoa
  • Seminal fluid
  • Prostate fluid
  • Liquid contributed by the bulbourethral glands
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3
Q

Major fraction of semen

A

Seminal fluid (60%-70%)

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4
Q

Identify percentage of semen composition: SPERMATOZOA

A

5%

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5
Q

Identify percentage of semen composition: SEMINAL FLUID

A

60%-70%

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6
Q

Identify percentage of semen composition: PROSTATE FLUID

A

20%-30%

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7
Q

Identify percentage of semen composition: BULBOURETHRAL GLANDS

A

5%

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8
Q

These are paired glands in the scrotum that contain the seminiferous tubules for the secretion of sperm.

A

Testes

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9
Q

(Higher/Lower) temperature is optimal for sperm development.

A

Lower

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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

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11
Q

These cells provide support and nutrients for the germ cells as they undergo mitosis and meiosis.

A

Specialized Sertoli cells

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12
Q

The process of sperm development by means of both mitosis and meiosis is termed as ____________.

A

Spermatogenesis

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13
Q

This is where sperm mature and develop flagella.

A

Epididymis

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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.

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15
Q

Major components of seminal fluid

A

Fructose
Flavin

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16
Q

This serves as the energy source of spermatozoa and is necessary for propelling of flagella.

A

Fructose

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17
Q

TRUE or FALSE:

In the absence of fructose, sperm do not display motility in the semen analysis.

A

TRUE

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18
Q

The gray appearance of semen is due to the presence of __________.

A

Flavin

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19
Q

Approximately 20% - 30% of the semen volume is acidic fluid and is produced by which gland?

A

Prostate gland

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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.

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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

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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.

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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.

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24
Q

Period of sexual abstinence prior to specimen collection (semen)

A

2-7 days

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25
Q

TRUE or FALSE:
Specimens collected following prolonged abstinence tend to have higher volumes and increased motility.

A

FALSE

NOTE:
Specimens collected following prolonged abstinence tend to have higher volumes and DECREASED motility.

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26
Q

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.

A

TRUE

NOTE:
Two abnormal samples will be considered significant.

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27
Q

When the specimen (semen) has to be transported to the laboratory, it must be kept at what temperature?

A

Room temperature

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28
Q

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.

A

TRUE

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29
Q

Specimens (semen) awaiting analysis should be kept at what temperature?

A

37°C

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30
Q

TRUE or FALSE:
In collecting semen, ordinary condoms may be used for collection if masturbation cannot be done.

A

FALSE

Only non-lubricant-containing rubber or polyurethane condoms should be used.

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31
Q

TRUE or FALSE:

Coitus interruptus is a recommended means of semen collection.

A

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.

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32
Q

TRUE or FALSE:

Semen analysis for fertility evaluation consists of both macroscopic and microscopic examination.

A

TRUE

NOTE:
The following are evaluated:
* Appearance
* Volume
* Viscosity
* pH
* Sperm concentration and count
* Motility
* Morphology

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33
Q

Characteristic odor of semen

A

Musty

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34
Q

Normal semen has a gray-white color and appears (transparent/translucent/turbid).

A

Translucent

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35
Q

Increased white turbidity of semen indicates the presence of which type of cells?

A

White blood cells

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36
Q

During microscopic examination, white blood cells must be differentiated from immature sperm cells which are also known as __________.

A

Spermatids

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37
Q

Strip test that may be used to screen for the presence of white blood cells in the semen.

A

Leukocyte esterase reagent strip test

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38
Q

TRUE or FALSE:
Varying amounts of red coloration in the semen are associated with RBCs and are abnormal.

A

TRUE

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39
Q

TRUE or FALSE:
Urine is toxic to sperm.

A

TRUE

NOTE:
This can affect sperm’s motility.

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40
Q

What would be the color of the sperm associated with prolonged abstinence, urine contamination, or certain medications?

A

Yellowish

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41
Q

This part of the male reproductive system mainly helps in propelling sperm to ejaculatory ducts.

A

Ductus deferens

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42
Q

The part of the male reproductive system that provide nutrients for sperm and fluid.

A

Seminal vesicles

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43
Q

The part of the male reproductive system that provide enzymes and proteins for coagulation and liquefaction.

A

Prostate gland

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44
Q

The part of the male reproductive system that add alkaline mucus to neutralize prostatic acid and vaginal acidity

A

Bulbourethral glands

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45
Q

Normal semen volume

A

2-5 mL

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46
Q

Normal viscosity of semen

A

Pours in droplets

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47
Q

Normal semen pH

A

7.2-8.0

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48
Q

Normal sperm concentration

A

> 20 million/mL

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49
Q

Normal sperm count

A

> 40 million/ejaculate

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50
Q

Normal sperm motility

A

> 50% within 1 hr

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51
Q

Normal sperm quality

A

> 2.0

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52
Q

Normal sperm morphology (% of normal forms) according to strict criteria

A

> 14% normal forms

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53
Q

Normal sperm morphology (% of normal forms) according to routine criteria

A

> 30% normal forms

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54
Q

Normal round cell count in semen

A

<1.0 million/mL

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55
Q

A normal semen specimen must liquefy within _____________ after collection.

A

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.

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56
Q

TRUE or FALSE:
Analysis of specimen cannot begin until liquefaction has occurred.

A

TRUE

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57
Q

If after 2 hours the semen specimen has not yet liquefied, what may be added to induce liquefaction?

A

Physiologic Dulbecco’s phosphate-buffered saline or proteolytic enzymes (alpha-chymotrypsin or bromelain)

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58
Q

TRUE or FALSE:
Gelatinous bodies present in liquefied semen has no clinical significance.

A

TRUE

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59
Q

INCREASED or DECREASED semen volume:
Extended abstinence

A

INCREASED

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60
Q

INCREASED or DECREASED semen volume:
Infertility

A

DECREASED

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61
Q

TRUE or FALSE:
Incompletely liquefied specimens are clumped and highly viscous.

A

TRUE

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62
Q

In performing semen dilution with physiologic saline, this is added to prevent precipitation.

A

Calcium chloride dehydrated solution

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63
Q

In performing semen dilution with physiologic saline, this is added to adjust the pH to 7.4

A

Sodium hydroxide

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64
Q

Preparation of 10 IU/mL bromelain in Dulbecco’s phosphate-buffered saline (dissolving) takes _______ minutes.

A

15-20 minutes

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65
Q

Droplets that form threads longer than _____ cm are considered highly viscous and abnormal.

A

2

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66
Q

In reporting semen viscosity, this rating means the sample is gel-like.

A

4

NOTE:

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

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67
Q

In reporting semen viscosity, this rating means the sample is watery.

A

0

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68
Q

Semen pH must be measured within _______ minutes.

A

60 (1 hr)

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69
Q

INCREASED or DECREASED semen pH:
Increased prostatic fluid

A

DECREASED

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70
Q

INCREASED or DECREASED semen pH:
Ejaculatory duct obstruction

A

DECREASED

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71
Q

INCREASED or DECREASED semen pH:
Infection within the reproductive tract

A

INCREASED

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72
Q

INCREASED or DECREASED semen pH:
Poorly developed seminal vesicles

A

DECREASED

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73
Q

Sperm concentration considered borderline.

A

10-20 million/mL

74
Q

Common listing for sperm concentration.

A

> 20-250 million sperm/mL

75
Q

Total sperm count formula:

A

(sperm concentration x specimen volume)

76
Q

This tool is used to perform sperm concentration

A

Neubauer counting chamber

77
Q

The most commonly used dilution in performing sperm count

A

1:20

78
Q

TRUE or FALSE:
Sperm count may be performed on diluted and undiluted specimens.

A

FALSE

NOTE:
Dilution of semen is essential to immobilize sperm before counting.

79
Q

Components of traditional diluting fluid used to immobilize sperm

A

Sodium bicarbonate
Formalin

80
Q

If sodium bicarbonate and formalin are not available as diluting fluid, this can be also used to produce good results.

A

Saline
Distilled water

81
Q

What parts of the Neubauer counting chamber are sperm counted?

A

Four corner and center squares of the large center square

NOTE:
This is similar to performing RBC count

82
Q

How long must the sperm be settled in the hemocytometer prior to actual counting?

A

3-5 minutes

83
Q

The sperm count on both sides of the hemocytometer must agree within ____%.

A

10

NOTE:
If the counts do not agree, dilution and counts are repeated.

84
Q

This stain is added to aid in sperm visualization when using bright-field microscopy.

A

Crystal violet

85
Q

Immature sperms and white blood cells are termed as ________.

A

Round cells

86
Q

TRUE or FALSE:

In sperm count, fully developed sperm and round cells are all included in the count.

A

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
Q

A WBC count of ___________ in semen is associated with infection of inflammation.

A

> 1 million leukocytes/mL

88
Q

A spermatid count of ____________ indicates disruption of spermatogenesis.

A

> 1 million spermatids/mL

NOTE: This may be caused by viral infections, exposure to toxic chemicals, and genetic disorders.

89
Q

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.

A

1,000,000

90
Q

TRUE or FALSE:
The presence of sperm capable of forward, progressive movement is critical for fertility.

A

TRUE

91
Q

TRUE or FALSE:
The practice of examining sperm motility at timed intervals over an extended period is a useful procedure.

A

FALSE

NOTE:
This method has been shown to serve no useful purpose.

92
Q

In evaluating sperm motility, how many high-power fields must be observed?

A

20 high-power fields

93
Q

Sperm motility is evaluated according to which two parameters?

A

Speed
Direction

94
Q

SPERM MOTILITY GRADING:
Rapid, straight-line motility

A

4.0

95
Q

SPERM MOTILITY GRADING:
Slower speed, some lateral movement

A

3.0

96
Q

SPERM MOTILITY GRADING:
Slow forward progression, noticeable lateral movement

A

2.0

97
Q

SPERM MOTILITY GRADING:
No forward progression

A

1.0

98
Q

SPERM MOTILITY GRADING:
No movement

A

0

99
Q

SPERM MOTILITY ACCORDING TO WHO CRITERIA:
Rapid, straight-line motility

A

a

100
Q

SPERM MOTILITY ACCORDING TO WHO CRITERIA:
Slower speed, some lateral
movement

A

b

101
Q

SPERM MOTILITY ACCORDING TO WHO CRITERIA:
Slow forward progression,
noticeable lateral movement

A

b

102
Q

SPERM MOTILITY ACCORDING TO WHO CRITERIA:
No forward progression

A

c

103
Q

SPERM MOTILITY ACCORDING TO WHO CRITERIA:
No movement

A

d

104
Q

TRUE or FALSE:
A minimum motility of 50% with a rating of 2.0 after 1 hour is considered normal.

A

TRUE

105
Q

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.

A

TRUE

106
Q

An alternative sperm motility grading criteria according to WHO Laboratory Manual for the Examination and Processing of Human Semen (2010) can either be ________, _________, or _________.

A
  • Progressive Motility
  • Nonprogressive motility
  • Immotility (IM)
107
Q

An alternative sperm motility grading which describes sperm moving linearly or in a large circle.

A

Progressive Motility (PM)

108
Q

An alternative sperm motility grading which describes sperm moving with an absence of progression.

A

Nonprogressive motility

109
Q

An alternative sperm motility grading which describes sperm having no movement.

A

Immotility

110
Q

This is an instrumentation that provides objective determination of both sperm velocity and trajectory. This also includes sperm concentration and morphology.

A

Computer-assisted semen analysis (CASA)

111
Q

TRUE or FALSE:
Abnormalities in tail morphology are associated with poor ovum penetration.

A

FALSE

NOTE:
* Abnormality in head morphology = poor ovum penetration
* Abnormality in tail morphology = Motility problems

112
Q

Normal length of flagellar tail

A

45 um

113
Q

Normal length and width of sperm head

A

5 um long, 3 um wide

114
Q

Specific part of the head of the sperm which is critical to ovum penetration.

A

Acrosomal cap (located at the tip of the head)

115
Q

The acrosomal cap must encompass approximately half of the head and cover what part (in fraction) of sperm nucleus?

A

2/3

116
Q

This part of the sperm attaches the head to the tail and the midpiece

A

Neckpiece

117
Q

Normal length of midpiece

A

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
Q

TRUE or FALSE:
Sperm motility can be evaluated at room temp or 37°C.

A

TRUE

119
Q

TRUE or FALSE:
In assessing sperm motility, it is important that the slides and cover slips are prewarmed.

A

TRUE

120
Q

Air-dried slides containing semen samples are stable for how many hours?

A

24 hours

121
Q

TRUE or FALSE:
An abnormally long neckpiece has no significant effect to sperm motility.

A

FALSE

NOTE:
An abnormally long neckpiece may cause the sperm head to bend backward and interfere with motility.

122
Q

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.

A

Kruger’s strict criteria

123
Q

These are the predominant form of leukocyte in semen.

A

Peroxidase-positive granulocytes

NOTE:
This can be differentiated from spermatogenic cells and lymphocytes using peroxidase stain.

124
Q

Calculation of round cells is done using what formula?

A

C = (N x S) / 100

  • N = number of spermatids or neutrophils counted per 100 mature sperm
  • S = sperm concentration in millions/mL
125
Q

If sperm abnormalities are discovered in routine parameters, additional testing may be requested. These tests include:

A
  • Sperm vitality
  • Seminal fluid fructose level
  • Sperm agglutinins
  • Microbial infection
126
Q

Identify the POSSIBLE ABNORMALITY given the following abnormal result:

Decreased motility with normal count

A

Vitality

127
Q

Identify the POSSIBLE ABNORMALITY given the following abnormal result:

Decreased count

A

Lack of seminal vesicle support medium

128
Q

Identify the POSSIBLE ABNORMALITY given the following abnormal result:

Decreased motility with clumping

A

Male anti-sperm antibodies

129
Q

Identify the POSSIBLE ABNORMALITY given the following abnormal result:

Normal analysis with continued infertility

A

Female anti-sperm antibodies

130
Q

Identify the POSSIBLE NORMALITY addressed by the following test:

Eosin-nigrosin stain

A

Vitality

131
Q

Identify the POSSIBLE NORMALITY addressed by the following test:

Fructose level

A

Lack of seminal support medium

132
Q

Identify the POSSIBLE NORMALITY addressed by the following test:

Mixed agglutination reaction and immunobead tests

A

Male anti-sperm antibodies

133
Q

Identify the POSSIBLE NORMALITY addressed by the following test:

Sperm agglutination with female serum

A

Female anti-sperm antibodies

134
Q

Identify the POSSIBLE NORMALITY addressed by the following test:

Sperm agglutination with male serum

A

Male anti-sperm antibodies

135
Q

Identify which TEST/S can be used to address the following sperm abnormalities:

Vitality

A

Eosin-nigrosin stain

136
Q

Identify which TEST/S can be used to address the following sperm abnormalities:

Lack of seminal vesicle supporting medium

A

Fructose level

137
Q

Identify which TEST/S can be used to address the following sperm abnormalities:

Male anti-sperm antibodies

A
  • Mixed agglutination reaction and immunobead tests
  • Sperm agglutination with male serum
138
Q

Identify which TEST/S can be used to address the following sperm abnormalities:

Female anti-sperm antibodies

A

Sperm agglutination with female serum

139
Q

Sperm vitality should be assessed within _____ hour of ejaculation.

A

1 hour

140
Q

In evaluating sperm vitality, the number of dead cells are counted in how many sperm?

A

100

NOTE:
This uses bright-field or phase-contrast microscopy

141
Q

What color are the living cells when using the eosin-nigrosin stain to evaluate sperm vitality?

A

Bluish white

NOTE:
Living cells are not infiltrated by the dye

142
Q

What color are the dead cells when using the eosin-nigrosin stain to evaluate sperm vitality?

A

Red against a purple background

143
Q

Normal vitality requires _____% or more living cells.

A

50%

144
Q

Presence of a large proportion of vital but immobile cells indicate problems with which part of the sperm?

A

Flagellum

145
Q

High number of immotile and nonviable sperm cells may indicate problems with what part of the male reproductive system?

A

Epididymis

146
Q

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.

A

Resorcinol test

147
Q

Normal fructose level

A

≥ 13 umol/ejaculate

148
Q

Semen specimens to be tested for fructose levels must be examined within _____ hour/s of collection.

A

2 hours

149
Q

When semen cannot be tested for fructose levels yet, what is the storage condition required?

A. Frozen
B. Room temperature
C. Refrigerated

A

A. Frozen

NOTE:
This is to prevent fructolysis.

150
Q

TRUE or FALSE:

Antisperm antibodies can be present in both men and women.

A

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
Q

Under normal conditions, this separates sperm from the male immune system.

A

Blood-testes barrier

152
Q

The procedure used to reverse vasectomy.

A

Vasovasostomy

153
Q

TRUE or FALSE:

Presence of antibodies in a male subject can be suspected when clumps of sperm are observed during a routine semen analysis

A

TRUE

154
Q

What is the mode of reporting of agglutination that occurs in anti-sperm antibodies?

A

“Few,” “Moderate,” “Many”

155
Q

These are the two frequently used tests to detect the presence of antibody-coated sperm

A
  • Mixed agglutination reaction (MAR) test
  • Immunobead test
156
Q

This is a screening procedure used primarily to detect the presence of IgG antibodies.

A

MAR test

157
Q

In performance of MAR test, a finding of less than ____% of the motile sperm attached to the particles is considered normal.

A

10%

158
Q

This test is a more specific procedure for detection of presence of antibody-coated sperm. This detects the presence of IgG, IgM, and IgA.

A

Immunobead test

159
Q

TRUE or FALSE:
Immunobead test is also capable of demonstrating which area of the sperm the autoantibodies are affecting.

A

TRUE

160
Q

What is added to the sperm in performing Immunobead test to detect antisperm antibodies?

A

Polyacrylamide beads coated with either anti-IgG, anti-IgM, or anti-IgA.

161
Q

In performance of Immunobead test, the presence of beads on ______% of the sperm is considered normal (as defined by WHO).

A

<50%

162
Q

Which organisms are frequently tested for when presence of more than 1 million leukocytes/mL is present in the semen.

A

Chlamydia trachomatis
Mycoplasma hominis
Ureaplasma urealyticum

163
Q

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?

A

epididymis

164
Q

(Increased/Decreased) zinc, citric acid, glutamyl transpeptidase, and acid phosphatase indicate a lack of prostatic fluid.

A

Decreased

165
Q

In testing for the presence of semen (e.g., cases of alleged rape), the specimen may be enhanced using what reagent?

A

Xylene

166
Q

How long can motile sperm be detected after intercourse?

A

24 hours

167
Q

How long can nonmotile sperm be detected after intercourse?

A

3 days

168
Q

When the sperm dies off, the heads remain and may be present for ______ days after intercourse.

A

7 days

169
Q

This enzyme is useful in detecting presence of semen in specimen as this is present in high concentrations in seminal fluid.

A

Prostatic acid phosphatase

170
Q

This antigen is a more specific method to detect presence of semen in a specimen as it is present despite absence of sperm.

A

Seminal glycoprotein p30 (Prostatic Specific Antigen)

171
Q

Normal values of neutral a-glucosidase in semen

A

≥20 mU/ejaculate

172
Q

Normal values of zinc in semen

A

≥2.4 umol/ejaculate

173
Q

Normal values of citric acid in semen

A

≥52 umol/ejaculate

174
Q

Normal values of acid phosphatase in semen

A

≥200 Units/ejaculate

175
Q

In postvasectomy semen analysis, specimens are routinely tested at monthly intervals, beginning at how many months postvasectomy?

A

2

NOTE:
The testing continues until two consecutive monthly specimens show no spermatozoa.

176
Q

In postvasectomy semen analysis, wet preparation detecting for the presence of motile and nonmotile sperm is done using ______ microscopy.

A

Phase

177
Q

A negative wet preparation for postvasectomy semen analysis involves specimen centrifugation for ______ minutes and examination of the sediment.

A

10

178
Q

TRUE or FALSE:
A single “motile” sperm on a wet preparation is an indication of an unsuccessful vasectomy.

A

TRUE

179
Q

A sperm function test wherein sperm are incubated with species-nonspecific hamster eggs and penetration is observed microscopically.

A

Hamster egg penetration

180
Q

A sperm function test involving observation of sperm’s ability to penetrate partner’s midcycle cervical mucus

A

Cervical mucus penetration

181
Q

A sperm function test where sperm exposed to low-sodium concentrations are evaluated for membrane integrity and sperm viability

A

Hypo-osmotic swelling

182
Q

A sperm function test involving evaluation of the acrosome to produce enzymes essential for ovum penetration

A

In vitro acrosome reaction

AUBF (5 decks)

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