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Liz's Urinalysis > Semen Analysis > Flashcards

Semen Analysis Flashcards

1
Q

Inability to conceive after one year of unprotected intercourse or the inability to carry pregnancy to term

A

Infertility

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2
Q

Located in the interstitium of the testes and are responsible for the production of testosterone

A

Leydig cells

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3
Q

Area b/w the seminiferous tubules; not part of the seminiferous tubules

A

Interstitium

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4
Q

Accessory glands that are responsible for approximately 70% of the ejaculate; contains high concentrations of flavin and fructose

A

Seminal vesicles

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5
Q

Accessory gland that is responsible for approximately 25% of the ejaculate; contains acid phosphatase, proteolytic enzymes, and zinc

A

Prostate gland

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6
Q

Secretes an alkaline mucus that serves to buffer the ejaculate to a slightly alkaline pH

A

Bulbourethral glands

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7
Q

List the order of the travel route of sperm (SEVEn UP)

A
  1. Seminiferous tubules
  2. Epididymus
  3. Vans deferns
  4. Ejaculatory duct
  5. Urethra
  6. Penis
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8
Q

Proper collection of seminal fluid

A
  • Collected through masturbation
  • Collect in a warm glass container
  • Store at 37°C until testing begins
  • Collect b/w 2-7 days of abstinence
  • Label w/ name, period of abstinence, and date/time of collection
  • Testing should begin w/in 1 hour of collection
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9
Q

Normal appearance of seminal fluid

A
  • Viscous

- Translucent gray/white

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10
Q

Abnormal appearance of seminal fluid

A
  • “Whiter” or more turbid = leukocytes
  • Red = expect RBCs
  • Yellow = urine, prolonged abstinence, certain meds
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11
Q

Normal viscosity of seminal fluid

A

Semen immediately coagulates after ejaculation and w/in 30 minutes the coagulum will liquify

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12
Q

Abnormal types of viscosity

A
  • Specimen isn’t liquefied by 60 minutes
  • If clumps or agglutination persists, possibly due to Abs
  • Watery samples due to few (if any sperm)
  • Mucus threads form that are greater than 2 cm
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13
Q

Normal volume for seminal fluid

A

2-5 mL

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14
Q

What does a volume of seminal fluid < 2 mL indicate?

A
  • Blockage
  • Infection
  • Congenital absence of seminal vesicles
  • Retrograde ejaculation
  • Loss of fluid
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15
Q

Normal pH for seminal fluid

A

7.2-8.0, slightly alkaline to neutralize acidic environment of vagina

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16
Q

What does a high pH of seminal fluid indicate?

A

Infections

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17
Q

What does a low pH of seminal fluid indicate?

A

A larger percentage of ejaculate volume is from the prostate gland or there are abnormalities in other sites

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18
Q

One of the most important factors for infertility testing, done on brightfield

A

Motility

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19
Q

How do you examine motility?

A
  • Prepare a wet mount and count percentage of sperm in each graded category (rapid progressive, moderately progressive, non-progressive, and immotile)
  • A sperm moves by rotating its tail in a spiral motion
20
Q

Normal sperm motility

A

≥50% in the two most motile groups if the specimen is evaluated w/in 60 minutes

21
Q

How do you analyze sperm concentration?

A
  • Dilute specimen
  • Load hematocytometer
  • Count 4 corner squares and red cell counting area
  • Count both sides and average
22
Q

Equation for calculating sperm concentration

A

((avg # sperm)/(L x W x D)) x dilution factor

23
Q

Normal concentration for sperm

A

200-250 million/mL, since sperm are reported in mL and no uL, you have to multiply by 1000

24
Q

Reasons for low sperm concentration

A
  • Anatomical defects
  • Short periods of abstinence
  • Loss of first portion of ejaculate
  • Low or absent fructose
25
Q

How do you calculate sperm count?

A

[sperm] x volume of ejaculate

26
Q

Normal sperm count

A

≥ 40 million

27
Q

When and why is a sperm count performed?

A
  • After postvasectomy, specimens are collected at monthly intervals beginning 2 months after surgery
  • Must have 2 monthly specimens w/ no sperm
  • Presence of motile sperm indicates unsuccessful procedure
  • Macroscopic results should still be normal
28
Q

How do you analyze morphology?

A
  • Prepare slide and air dry
  • Stain w/ Wright’s Giemsa, or Papanicolaou
  • Rate under oil immersion (1000x), count defective sperm and type of defect
29
Q

Normal percentage of normal sperm morphology

A

12-15% or greater

30
Q

What percentage of normal sperm indicates a strong predictor of infertility?

A

< 5% normal sperm

31
Q

What is the teratozoospermia index (TZI)?

A
  • Number of defects divided by a total number of abnormal sperm
  • Should be ≤1.6, helpful in predicting sperm function
32
Q

What would be the cause of abnormal morphology

A
  • Anatomical defects
  • Physiological problems
  • Infection
  • Scrotal heating
  • Frequent ejaculations
33
Q

Two stains useful in examining vitality

A

Blom’s Stain or eosin nigrosin will allow rapid differentiation between alive and dead sperm, where dead sperm take up stain and appear dark pink and live sperm do not take up stain and appear white

34
Q

Normal vitality

A

≥50% are more alive in normal men

35
Q

What do leukocytes in ejaculate indicate?

A

Should be < 1 million/uL of seminal fluid otherwise indicate infection or inflammation

36
Q

What is measured in rape investigations?

A
  • Look for motile sperm (24 hours) or immotile sperm (3 days)
  • Acid phosphatase measurement
  • PSA
37
Q

______ is the only body fluid with high concentration of acid phosphatase and can be measured in vaginal fluid or from skin or clothing

A

Semen

38
Q

Semen is routinely analyzed to evaluate what?

A

Post-vasectomy status

39
Q

Following liquefaction, what should the viscosity of the ejaculate look like?

A

Viscosity is similar to water

40
Q

A semen pH > 8.0 is associate with what?

A

An infection in the male reproductive tract

41
Q

Vitality staining with these two stains enables rapid differentiation b/w alive and dead sperm

A

Blom’s and eosin nigrosin

  • Dead sperm take up the stain and appear pink, live sperm appear white
  • Serves as a confirmation for motility
42
Q

What else could be found in the ejaculate?

A
  • Leukocytes (< 1 million/mL; if higher, indicates infection or inflammation)
  • Sperm precursors
  • Urethral epi cells
  • Cellular debris
43
Q

Normal of combined leukocytes and sperm precursors (round cells) in seminal fluid

A

≤ 5 million/mL

44
Q

Two tests that test for Abs against sperm

A
  • Mixed agglutination rxn

- Immunobead test

45
Q

Mixed agglutination

- Principle

A

AHG is mixed w/ latex beads coated w/ IgG. AGH binds to latex beads and sperm simultaneously in the presence of a sperm Abs

46
Q

Immunobead test

- Principle

A

Sperm are added to a solution containing latex beads that are coated w/ anti-IgG (anti-IgM or anti-IgA). Microscopic analysis indicates whether the Abs are directed against the head or the tail

Liz's Urinalysis (6 decks)

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