Seminal Fluid

Question 1

Seminal fluid purposes

Answer 1

Transport sperm
Why examine?: infertility and vasectomy work ups, donation, forensic

Question 2

Seminal fluid make up

Answer 2

Spermatozoa produced by testis and matured by epididymis

Fluid: seminal vesicles, prostate gland, bulbourethral glands - for nutrition, motility

Question 3

Ssample collection process

Answer 3

Edge for 2-3 days, 3 samples over 3 month period
- Body temp, eval within 1hr’
- Complete collection

Question 4

What is affected by sperm count and WBCs?

Answer 4

Clarity

Question 5

Volume for sperm collection

Answer 5

2-5 mls

Question 6

Other important features and grading of semen

Answer 6

Viscosity: slightly visvous, drop test, grade 0-4, 4 being like gel and 0 like water

Question 7

Liquefaction

Answer 7

Semen coagulates immediately
30-60 mins to liquify again
>60 mins or no coag at all is abnormal

How to manually break up coaged semen: amylase, bromelin

Question 8

Oligospermia

Answer 8

<20 million mL

Question 9

Azoospermia

Answer 9

No sperm

Question 10

Sperm motility count rating

Answer 10

0: non motile
1: non progressive / motion but not forward
2: slow progressive / non linear
3: slow progressive / moderate linear
4: rapid progressive / strong linear

Question 11

Calculation for motile sperm

Answer 11

1. count immobile
2. immobilize all and count all

Formula: (total count - immotile count)/total count

Question 12

Normal motility percentage

Answer 12

80% with 3-4 grade motility

Question 13

Why test immobile sperm?

Answer 13

Check if actually non motile and alive or just dead

Question 14

How to test immobile sperm

Answer 14

Supravital eosin stain: if damaged cell membrane then it is dead

Normal: 75% viable

Question 15

How to check for anti sperm antibodies

Answer 15

Agglutination with head-head or tail-tail pattern

Question 16

How to check penetration quality

Answer 16

Post-sex cervical mucus collected = if many sperm, good

Question 17

Abnormalities in sperm

Answer 17

Normal, not necessarily associated with one particular disease

Normal can be 30-70%
<= 5% is infertile
<= 30% is subfertile

Question 18

Acrosome abnormalities

Answer 18

No acrosome: round head syndrome, globozoospermia
INFERTILE

Question 19

Other cells in semen

Answer 19

Epis
WBCs
- >1 million/ml usually inflammation, damage to sperm, gland related

Prostate/germ cells

RBCs +/ bacteria always report

Question 20

Immature sperm abnormal and causes

Answer 20

Abnormal if >2%
- Structural abnormalities
- Testicular stress
- Heavy alcohol consumption

Question 21

Cell diff of semen

Answer 21

count 100 sperm

(# cell type x sperm concentration) / 100

Question 22

Infection effects on sperm

Answer 22

UG infections cause 15% of infertility - normal flora or STDs

Bugs - anti sperm Ab mimic
Yeast - impairs mobility

Question 23

Fructose in semen uses and ranges

Answer 23

Energy, metabolism, motility
- seminal vesicles

Normal >= 13umol/sample
Test when decreased sperm count or viability

Question 24

Normal pH of semen

And changes and their cause

Answer 24

7.2-8.0

Decreased: physiological abnormalities
Increased: infections

Question 25

Important chemical tests

2

Answer 25

Acid phosphatase: rape kits
Zinc, citric acid: prostate gland function

Question 26

Signs of infertility

Answer 26

• <20 million/ul or >250 million/ul
• <80% w forward motility
• <75% viable
• agglutination +
• decreased mucous penetration
• > 60 min liquefaction or no coag