Semen Analysis Flashcards
It is an admixture of spermatozoa suspended in secretions from the glandular tissue of the male genital system
Normal semen
This originates from the prostate gland and gives semen its characteristic odor
Preliminary Fraction
It originates from the seminal vesicles, testes, epididymis and partially from the prostate gland.
Main Fraction
It is formed by secretions of seminal vesicles and is entirely gelatinous in consistency, with large number of immotile spermatozoa
Terminal Fraction
It is clear secretion of Cowper’s or Litter’s glands and contains proteins with moderately viscous consistency
Pre – Ejaculatory Fraction
They contain majority
of the spermatozoa
preliminary fraction and main fraction
This refers when pregnancy is never achieved by the patient
Primary infertility
Refers to when a patient at least had one prior pregnancy
Secondary infertility
What are the four fractions of ejaculate?
- Pre-Ejaculatory Fraction
- Preliminary Fraction
- Main Fraction
- Terminal Fraction
What is the main prostatic enzyme that can be found in the semen?
Acid phosphatase
What does ICSI mean?
Intra-Cytoplasmic Sperm Injection
These are procedures in order for patients to have a chance for fertility
- ICSI = Intra-Cytoplasmic Sperm Injection (Male)
- IVF= In-Vitro Fertilization (Female)
It is the cutting, tying, or sealing of the vas deferens in order to prevent sperm cells from entering to the urethra
Vasectomy
It contains enzymes that breaks down the outer membrane of egg shells
Acrosome
4-5 um and where energy for motility is generated
Mid piece
It protects sperm against extra cellular injuries
Plasma membrane
How long is a human sperm cell?
70 um long
50%, Contributes to alkaline levels of semen, half of the volume of the semen.
Seminal vesicles
20%, Contributes to slightly acidic levels.
Prostate glands
It contains citric acid, flavin, fructose and K for nutritional support
Seminal vesicles
Storage; where mature &
immature sperm cells wait
Epididymis and
Vasa deferentia
Where Sertoli cells are located;
Seminiferous
tubules
Where spermatogenesis is being
channeled; support &
nourishment of sperm happens
Sertoli Cells
Sperm formation is estimated to be how long?
74 day process
Terminology: No spermatozoa in semen
Azoospermia
Terminology: Semen volume <1.5 ml
Hypospermia
Terminology: No semen volume
Aspermia
Terminology: normal semen volume
Normospermia
Terminology: Semen volume >6.0 ml
Hyperspermia
Terminology: Red blood cell present in semen
Hematospermia
Terminology: Leukocytes present in semen
Leukospermia
What is the normal range for immature forms in semen analysis?
<2%
What is the normal range for fructose in semen analysis?
1+ to 4+
What is the normal range for epithelial cells in semen analysis?
None to few
What is the normal range for bacteria in semen analysis?
None
What is the normal range for penetration in semen analysis?
> 30 mm
What is the normal range for RBCs in semen analysis?
None
What is the normal range for Leukocytes in semen analysis?
None to occasional
Non-specific agglutination and results to accessory gland infection
Sperm to non sperm elements
Site specific agglutination and results to anti sperm antibodies
Sperm to sperm agglutination
Absence of sperm. Seen in abnormal spermatogenesis, ejaculatory dysfunction or obstruction
Azoospermia
Abnormally lower sperm concentration
Oligospermia
Abnormally elevated sperm concentration
Polyzoospermia
It is rare and may be cause by a long period of abstinence. Can also be associated with sperm of poor quality.
Polyzoospermia
It is the most important predictor of the functional
aspect of spermatozoa
Motility
What are the causes of Asthenospermia?
- Inherent defects of sperm
- Artifactual – spermicides, lubricants, or rubber
condoms - Prolonged Abstinence Periods
- Genital Tract Infection- Inherent defects of sperm
- Artifactual – spermicides, lubricants, or rubber
condoms - Prolonged Abstinence Periods
- Genital Tract Infection
Habitual Factor: High intake of soya results in?
decrease sperm density
Habitual Factor: High consumption of
tobacco results in?
Decrease sperm density / motility.
Habitual Factor: Consumption
of coccaine/marijuana and vaginal lubricant results in?
decrease sperm motility
Habitual Factor: Alcoholism affects?
affects all semen parameters
A pH that is more acidic is caused by?
lactic acid production with high sperm counts (Congenital Aplasia of vasa deferentia and seminal vesicles)
A pH that is more alkaline is caused by?
loss of C02 over time (Reproductive tract infection)
What is the simplest way to measure semen pH
Nitrozine paper
This enzyme is used to evaluate secretory function of the prostate
Acid Phosphatase
This is produced by the seminal vesicle and functions to provide energy for spermatozoa
Fructose
What are the possible causes of low fructose?
Presence of ejaculatory duct obstruction, androgen deficiencies, decreased testosterone levels and azoospermia
Maturation of spermatozoa takes place in the:
Epididymis
Enzymes for the coagulation and liquefaction of semen are
produced by the:
Prostate gland
The major component of seminal fluid is:
Fructose
If the first portion of a semen specimen is not collected, the
semen analysis will have which of the following?
A. Decreased pH
B. Increased viscosity
C. Decreased sperm count
D. Decreased sperm motility
C. Decreased sperm count
Failure of laboratory personnel to document the time a
semen sample is collected primarily affects the interpretation of semen:
Viscosity
Liquefaction of a semen specimen should take place within:
1 hour
A semen specimen delivered to the laboratory in a condom
has a normal sperm count and markedly decreased sperm
motility. This indicates:
Antispermicide in the condom
An increased semen pH may be caused by:
A. Prostatic infection
B. Decreased prostatic secretions
C. Decreased bulbourethral gland secretions
D. All of the above
D. All of the above
Proteolytic enzymes may be added to semen specimens to:
Decrease the viscosity
The normal sperm concentration is:
More than 20 million/mL
Given the following information, calculate the sperm concentration: dilution, 1:20; sperm counted in five RBC
squares on each side of the hemocytometer, 80 and 86;
volume, 3 mL
83 million/mL
Using the same information, calculate the sperm count when 80 sperm are counted in 1 WBC square and
86 sperm are counted in another WBC square
The primary reason to dilute a semen specimen before
performing a sperm concentration is to:
Immobilize the sperm
When performing a sperm concentration, 60 sperm are
counted in the RBC squares on one side of the hemocytometer and 90 sperm are counted in the RBC squares on the other side. The specimen is diluted 1:20. The:
A. Specimen should be rediluted and counted
B. Sperm count is 75 million/mL
C. Sperm count is greater than 5 million/mL
D. Sperm concentration is abnormal
A. Specimen should be rediluted and counted
Sperm motility evaluations are performed:
A. Immediately after the specimen is collected
B. Within 1 hour of collection
C. After 3 hours of incubation
D. At 6-hour intervals for 1 day
B. Within 1 hour of collection
The percentage of sperm showing average motility that is
considered normal is:
B. 50%
The purpose of the acrosomal cap is to:
Penetrate the ovum
The sperm part containing a mitochondrial sheath is the:
Midpiece
All of the following are associated with sperm motility
except the:
A. Head
B. Neckpiece
C. Midpiece
D. Tail
A. Head
The morphologic shape of a normal sperm head is:
Oval
Normal sperm morphology when using the WHO criteria is:
> 30% normal forms
Additional parameters measured by Kruger’s strict morphology include all of the following except:
A. Vitality
B. Presence of vacuoles
C. Acrosome size
D. Tail length
A. Vitality
Round cells that are of concern and may be included in
sperm counts and morphology analysis are:
Leukocytes and Spermatids
If 5 round cells per 100 sperm are counted in a sperm morphology smear and the sperm concentration is 30 million, the concentration of round cells is:
1.5 million
Following an abnormal sperm motility test with a normal
sperm count, what additional test might be ordered?
Eosin-nigrosin stain
Follow-up testing for a low sperm concentration would
include testing for:
Seminal fluid fructose
The immunobead test for antisperm antibodies:
A. Detects the presence of male antibodies
B. Determines the presence of IgG, IgM, and IgA antibodies
C. Determines the location of antisperm antibodies
D. All of the above
D. All of the above
Measurement of α -glucosidase is performed to detect a
disorder of the:
Epididymis
A specimen delivered to the laboratory with a request
for prostatic acid phosphatase and glycoprotein p30 was
collected to determine:
A. Prostatic infection
B. Presence of antisperm antibodies
C. A possible rape
D. Successful vasectomy
C. A possible rape
Following a negative post vasectomy wet preparation, the
specimen should be:
A. Centrifuged and reexamined
B. Stained and reexamined
C. Reported as no sperm seen
D. Both A and B
A. Centrifuged and reexamined
Standardization of procedures and reference values for
semen analysis is primarily provided by the:
WHO
