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Clinical Chemistry > Semen > Flashcards

Semen Flashcards

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1
Q

Semen: Composition

A 
Fluid from seminal vesicles 
comprises over half the volume of semen
contains citric acid, flavins, fructose, and potassium
Testis contribute spermatozoa
Fluid from prostate gland
comprises about 20% the volume of semen
contains acid phosphatase, citric acid, and proteolytic enzymes
Small amounts of fluids from 
bulbourethral glands
Epididymis
urethral glands
vasa deferentia
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2
Q

Male Reproductive System

A

Detail of the male reproductive system

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3
Q

Spermatogenesis

A

Sertoli cells of seminiferous tubles of the testis
Controlled by testosterone, LH and FSH
Maturation phases completed in the epididymis
Process takes approximately 74 days
The process of spermatogenesis
Stage of transformation from human spermatid into spermatozoo

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4
Q

Semen: Specimen Collection and Handling

A 
Masturbation
After a 48- to 72-hour continence
Patients should have private room
Written and oral instructions
Wide-mouth clean collection container
 Properly labeled and delivered to lab within 30-60 minutes.
Record any loss of specimen.
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5
Q

Semen: Liquefaction

A

Specimen is observed immediately for coagulum.
Specimen is observed at 30 minutes and 60 minutes after collection for liquefaction.
Normal liquefaction occurs between 30 and 60 minutes after collection.
Specimens that do no liquefy may require treatment with amylase so that counts can be performed.

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6
Q

Semen: Volume

A

Measured using serological pipette
Recorded to one decimal place.
Normal 2.0 to 5.0 ml
High and low volumes may indicate infertility

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7
Q

Semen: Viscosity

A

Normal semen viscosity test

abnormal = watery consistency

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8
Q

Semen: Sperm Motility

A

Analysis within 1 hour of specimen collection.
Observation on high dry (400x).
Subjective evaluation of motility
1) High-motile, Low-motile, Non-motile
2) Progressive, Non-progressive, and Non-motile
3) strong linear progression, linear progression moderate, slow nonlinear progression, non-progressive, and non-motile
Percent in each category or percent motile only.
Normal = 60% or higher progressively motile sperm.
Alternate method: High-resolution video photography
Wet mount of semen. Many sperm are present
Wet mount of semen. Several sperm can be seen along with a red blood cells (R) and a white blood cell (W)

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9
Q

Semen: Sperm Concentration

A

Inclusion criteria of counting cells
Number counted x dilution factor x 10 / Area in sq mm.
85 cells on 1:00 dilution of the specimen in 9 sq. mm. =
85 x 100 x 10 / 1 = 85,000/cumm
85000 x 1000 = 85,000,000/cc
Normal 20 to 250 million per ml (cc).
Oligospermia = less than 20 million per milliliter.
Azoospermia is the complete absence of sperm.
Low counts may be caused by:
chromosomal disorders
ductal obstruction
gonadotropin deficiency
hyalinization of the seminiferous tubules
maturation arrest
pituitary disorders
radiation, drugs
renal failure
Sertoli-cell-only syndrome (Seroli cells support sperm growth)
vasectomy

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10
Q

Semen: Sperm Agglutination

A

Observed while performing motility evaluation.
Few clumps are normal.
Distinctly head-to-head or tail-to-tail clumping may indicate the presence of antisperm antibodies.
IgG
IgA

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11
Q

Semen: Sperm Viability

A 
Eosin stains dead sperm
Live sperm remain unstained
Nigrosin may be used for contrast
Performed as a supravital stain
Stain added to drop of fresh sample
Smear is made and allowed to dry
Evaluated on oil immersion (1000x)
Reported as % viable
Normal >75%
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12
Q

Viable sperm

A

picture

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13
Q

Nonviable sperm

A

picture

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14
Q

Semen: Sperm Penetration

A

Bovine cervical mucous filled flat glass tube
Placed vertically into small amount of specimen
Incubated for 90 minutes
Distance traveled by vanguard sperm is recorded
Normal = > 30mm

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15
Q

Sperm Morphology - Normal

A

Flattened oval head 4-5 um in length and 2-3 um wide
65% nuclear material with an acrosomal cap
Elongated tailpiece 50-55 um in length and 1-0.1 um neck to tip.
Four distinct regions.
Neckpiece
Midpiece
Mainpiece
Endpiece

Normally at least 70% of sperm demonstrate normally morphology.

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16
Q

Normal sperm

A

picture

Normal sperm. The arrow points to a sperm observed with a side view

17
Q

Sperm Morphology - Abnormal

A 
Head anomalies
Acrosomal abnormalities
Constricted head 
Double-headed
Flat-headed
Tapering head
Giant head
Pin head
Nuclear abnormalities
Vacuolation
Tail anomalies
Coiled tail
Cytoplasmic extrusion mass
Bent neck
Double-tailed
Multiple tails
Variation in tail legnth
Immature forms
18
Q

Double-tailed sperm

A

picture

19
Q

Coiled-tailed sperm

A

picture

20
Q

Flat-headed sperm

A

picture

21
Q

Normal sperm and another with a constricted neck

A

picture

22
Q

Various sperm head sizes

A

picture

23
Q

Various sperm anomalies

A

performing a semen analysis include determining the effectiveness of a vasectomy, rape-case
forensic studies, sperm donor evaluation, and paternity cases.
Picture

24
Q

These sperm both have bent neck pieces.

A

picture

25
Q

These sperm have round heads rather than oval

A

picture

26
Q

These sperm all have tapered heads rather than oval

A

Semen consists of several fluids produced in various male reproductive organs. The slightly alkaline fluid from seminal
vesicles comprises over half the volume of semen and contains citric acid, flavins, fructose, and potassium. These
substances provide nutritional support for spermatozoa.
Spermatozoa are formed in the testis and are stored in the epididymis and vasa deferentia. The prostate gland contributes a slightly acidic fluid containing acid phosphatase, citric acid, and proteolytic enzymes. These substances account for about 20% of the semen’s volume.
The remaining reproductive organs, bulbourethral glands, epididymis, urethral glands, and vasa deferentia, contribute little additional volume to
the semen.
Upon ejaculation, the fluids from all of these sources form the mixture, semen.

27
Q

The heads of these sperm all contain vacuoles

A

picture

28
Q

The necks of these sperm have excessive cytoplasmic membrane remaining

A

The preferred method of semen collection is by masturbation. This procedure ensures the opportunity to collect the entire ejaculate.
Collection should be performed after a 48- to 72-hour continence (abstinence from sexual activity) to provide a specimen containing the most accurate sperm
count and viability.
A private, comfortable room should be provided for specimen collection that allows for quick delivery of the specimen to the laboratory.
Written and verbal instructions for the procedure should be provided. Specimen collection containers should be clean glass or plastic and have a wide
opening. Specimens should not be collected in a condom as these often contain spermicidal compounds and lubricants that may interfere with laboratory tests.
If the specimen must be transported from a site distant to the laboratory, it must be kept near body temperature and extremes in temperature must be avoided.
Shortly after ejaculation, the semen coagulates because of the action of a clotting enzyme, formed in the prostate, on a fibrinogen-like precursor substance that is produced by the seminal vesicles.
Liquefaction occurs within 30–60 minutes. Ideally, the specimen should arrive in the laboratory as soon after collection as possible so that an accurate liquefaction

29
Q

Immature spermatids

A

picture

30
Q

Chemical Analysis -pH

A 
Measure within one hour of collection
Nitrozine paper method
Normal = 7.2 to 7.8
Acidic
Congenital aplasia of vasa deferentia and seminal vesicles
Alkaline
reproductive tract infection
Additional tests may include acid phophatase, fructose, and various hormones.
31
Q

Chemical Analysis – Acid Phosphatase

A

Evaluates secretory function of prostate
Normal levels => 200 units.
Also used as evidence in criminal cases.

32
Q

Chemical Analysis - Fructose

A 
Provides energy for spermatozoa
Produced by seminal vesicles
Normal level => 13 mol/ ejaculate
Low levels (accompanied by azoospermia)
ejaculatory duct obstruction
abnormalities in the vas deferens
Correlate with androgen deficiency
Correlate with decreased testosterone levels
33
Q

Chemical Analysis-Hormones

A 
Testosterone decreased 
gonadotropin deficiency
LH decreased
gonadotropin deficiency
FSH decreased 
gonadotropin deficiency
Hyalinzation of the seminiferous tubules
FSH increased
Seroli-cell-only syndrome
All three normal in ductal obstruction or maturation arrest of spermatozoa
34
Q

Semen: Immunology

A

Autoimmune antibodies to sperm form as a result of:
Trauma
Infections
Isoimmune antibodies directed against husband’s sperm can develop in women.
Individual specific
Broader reaction with all human spermatozoa

35
Q

Semen: Microbiology

A 
Urogenital infections account for 15% cases of male infertility.
Most common organisms:
Ureaplasma urealyticum
Mycoplasma hominis,
Chlamydia trachomatis
Herpes simplex.
Candida albicans

Clinical Chemistry (8 decks)

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