Semen analysis Flashcards
____________ is an admixture of spermatozoa suspended in secretions from the glandular tissue of the male genital system.
Normal Semen
How many fractions does an ejaculate have?
four fractions:
- Pre-Ejaculatory fraction
- Preliminary fraction
- Main fraction
- Terminal fraction
Which fraction consists a clear secretion of Cowper’s or Litter’s glands and contains proteins with moderately viscous consistency, which may possibly serve to neutralize residues of urine
Pre-ejaculatory fraction
Which gland functions to neutralize residues of urine?
Bulbourethral gland (Cowper’s or Litters gland)
Which fraction originates from the prostate gland. It gives semen its characteristic odor. It contain enzymes which liquefies the spermatozoa coagulum
Preliminary fraction
What is the function of the prostate gland?
- produces enzymes which serve to liquefy the spermatozoa coagulum
- gives the semen its characteristic odor
What is the function of the prostate gland?
It originates from the seminal vesicles, testes, epididymis and partially from the prostate gland.
Main fraction
which fraction/s contain majority of spermatozoa?
- preliminary fraction
- main fraction
Formed by secretions of seminal vesicles and is entirely gelatinous in consistency, with large number of immotile spermatozoa
Terminal fraction
what are the main enzyme and main sugar needed for sperm?
- acid phosphatase
- fructose
define and describe primary and secondary infertility?
- primary infertility refers when pregnancy is never achieved by the patient
- secondary infertility refers to when a patient at least had one prior pregnancy
What are the purposes of of performing tests for semen analysis?
- investigation of infertility
- identify treatment options
- determine suitability of semen for ICSI/IVF
- Pre and post-vasectomy confirmation
Define ICSI
intra Cytoplasmic Sperm Injection - male infertility
Define IVF
in vitro fertilization - female infertility
is procedure that involves cutting, tying, or sealing of the vas deferens in order to prevent sperm cells from entering to the urethra
vasectomy
length of the human sperm cell
70um
*4-5um
*Nucleus contains 23 *chromosomes Acrosome
Head
*4-5um
*where energy for motility is generated
Midpiece
contains enzymes that breaks down the outer membrane of egg shells
Acrosome
contains enzymes that breaks down the outer membrane of egg shells
Acrosome
Protects sperm against extracellular injuries
plasma membrane
tail measures about _________
55um
where spermatozoa is formed
Testis
50%, Contributes to alkaline levels of semen, half of the volume of the semen.
Seminal vesicles
the seminal vesicles contains what substance for sperm nutritional support?
Flavin, Fructose and Potassium (K)
20%, Contributes to slightly acidic levels.
Prostate gland
the prostate gland contains which substances?
acid phosphatase, citric acid and proteolytic enzymes
Storage; where mature & immature sperm cells wait
Epididymis & vasa deferentia (vas deferens)
where Sertoli cells are located
seminiferous tubules
where spermatogenesis is being channeled; support & nourishment of sperm happens
sertoli cells
sperm formation has an estimated ___________ process
74 day
enumerate the standard guidelines for sperm collection
1) There should be 2 to 7 days of sexual abstinence before collection
2) Two separate samples at least 7 days apart should be analyzed
3)The duration of abstinence should be constant
4) Masturbation in a clinical setting is the recommended procedure
5) Must be collected in a pre warmed, sterile, non- toxic, wide-mouthed container
T or F: passing of urine should be neglected upon semen collection
False
T or F: Wash hands with soap and dry
True
T or F: Glans and the penis may not necessarily be
cleaned with wet paper towel
False
T or F: use of lubricants is avoided upon semen collection since it has a potential to interfere with sperm motility
True
what are the conditions when First portion is missing?
sperm count decreased, falsely increased pH and specimen will not liquefy
what are the conditions when Last portion is missing?
semen volume decreased, sperm count will falsely increase, pH will falsely decrease, and specimen will not clot
70% of sperms are found at which portion?
First portion
Inclusions for labelling of semen specimen
- Patient’s name
- Age
- Doctor’s name
- Laboratory analysis form
> period of abstinence (in days)
> date and time of collection
> Mode of collection
> Time interval from collection to analysis
normal semen volume
Normospermia
no semen volume
Aspermia
semen volume <1.5 mL
Hypospermia
semen volume > 6.0 mL
Hyperspermia
No spermatozoa seen
Azoospermia
presence of leukocytes in semen
Leukospermia
presence of RBC in semen
Hematospermia
presence of dead sperm cell in semen
Necrospermia
presence of dead sperm cell in semen
Necrospermia
Normal analysis report
Liquefaction:
Color:
Viscosity:
pH:
Concentration:
- Liquefied under 30 minutes
- White or grayish white
- Viscous
- 7.2 to 7.8
- 20 to 250 million/mL
Normal analysis report
Agglutination:
Motility:
Penetration:
Viability:
Normal morphology:
- None
- > 60% progressively motile
- > 30mm
- 75%
- > 70
Normal analysis report
Leukocyte:
Red blood cell:
Epithelial cell:
Bacteria:
Fructose:
- None to occasional
- None
- None to few
- None
- 1+ to 4+
*sperm form clumps
Sperm agglutination
which condition causes sperm to non-sperm element agglutination?
- accessory gland infection
which condition causes sperm to sperm agglutination?
- anti sperm antibodies
What methods must be employed when sperm agglutination is observed?
- semen culture
- antibody assessments
units for sperm concentration & sperm count
- # sperm cell / mL
- # sperm / ejaculate
Azoospermia is seen in what following conditions?
- abnormal spermatogenesis
- ejaculatory dysfunction or obstruction
abnormally lower sperm concentration
Oligospermia
abnormally elevated sperm concentration
Polyzoospremia
Most important predictor of the functional aspect of spermatozoa
Sperm Motility
sperm motility can evaluate two conditions such as?
- normal development of axoneme
- normal maturation within epididymis
Disadvantages of sperm motility assessment
- Assessment of this parameter is subjective and has potential for technical mistakes
- In vitro motility of sperm may not reflect the true motility within the female reproductive tract
this refers to the infertility condition of reduced sperm motility
Asthenospermia
causes for asthenospermia
- inherent defects of sperm
- artifactual (spermicides, lubricants, condoms)
- Prolonged abstinence periods
- Genital tract infection
Habitual factors affecting sperm motility
High intake of soya : __________
___________ : decrease sperm motility/ density
- decrease sperm density
- High consumption of tobacco
Habitual factors affecting sperm motility
high consumption of cocaine or marijuana : _______________
__________ : decrease sperm motility
- decrease sperm motility
- vaginal lubricants
Habitual factors affecting sperm motility
Alcoholism
- affects all semen parameters
More acidic = ?
lactic acid production with high sperm counts (Congenital Aplasia of vasa deferentia and seminal vesicles)
More alkaline = ?
loss of C02 over time (Reproductive tract infection)
is the simplest way to measure semen pH
Nitrozine paper
Used to evaluate secretory function of the prostate
Acid phosphatase
Provides energy for spermatozoa
Fructose
Fructose is produced in?
seminal vesicles
What are the following conditions that is caused by low fructose?
- ejaculatory duct obstruction
- androgen deficiencies
- decreased testosterone levels
- azoospermia
