Seminal Fluid Analysis

Question 0

These are located in the interstitium of the testes and are responsible for the production of testosterone

Answer 0

Leydig cells

Question 1

This is the inability to conceive after one year of unprotected intercourse or the inability to carry pregnancy to term.

Answer 1

Infertility

Question 2

This is the area between the seminiferous tubules; not part of the seminiferous tubules

Answer 2

Interstitium

Question 3

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

Answer 3

Seminal Vesicles

Question 4

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

Answer 4

Prostate Gland

Question 5

These secrete an alkaline mucous that serves to buffer the ejaculate to a slightly alkaline pH

Answer 5

Bulbourethral Glands

Question 6

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

Answer 6

1 seminiferous tubules
2 epididymis
3 vans deferens
4 ejaculatory duct
5 urethra
6 penis

Question 7

How would you collect seminal fluid?

Answer 7

collected through masturbation in a warm glass container, store at 37*C until testing begins, collect between 2-7 days of abstinence, label (name, period of abstinence, date, time of collection); testing should begin within 1 hour of collection

Question 8

What is the normal appearance of seminal fluid?

Answer 8

viscous, translucent gray/white

Question 9

What is an abnormal appearance of seminal fluid?

Answer 9

1 Whiter or more turbid=leukocytes
2 Red=expect RBCs
3 Yellow=urine, prolonged abstinence, certain medications

Question 10

Describe normal viscosity of seminal fluid

Answer 10

semen immediately coagulates after ejaculation and within 30 minutes the coagulum will liquify

Question 11

What types of viscosity are abnormal?

Answer 11

specimen isn’t liquified by 60 minutes, clumps or agglutination persists due to antibodies, watery samples due to few/if any sperm, mucous threads form that are greater than 2cm

Question 12

What is the normal volume for seminal fluid?

Answer 12

2-5 mL

Question 13

What does a volume of seminal fluid less than 2 mL indicate?

Answer 13

blockage, infection, congenital absence of seminal vesicles, retrograde ejaculation, or loss of fluid

Question 14

What is the normal pH for seminal fluid?

Answer 14

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

Question 15

What does a high pH of seminal fluid indicate?

Answer 15

infections

Question 16

What does a low pH of seminal fluid indicate?

Answer 16

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

Question 17

This is one of the most important factors for infertility testing, done on brightfield

Answer 17

motility

Question 18

How do you examine motility?

Answer 18

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

Question 19

What is normal sperm motility?

Answer 19

> or equal to 50% in the two most motile groups if the specimen is evaluated within 60 minutes

Question 20

How do you analyze sperm concentration?

Answer 20

dilute specimen, load hemacytometer, count 4 corner squares and red cell counting area, count both sides and average

Question 21

What is the equation for concentration of sperm?

Answer 21

((avg # of sperm)/(l x w x d)) x dilution factor

Question 22

What is a normal concentration for sperm?

Answer 22

20-250 million/mL, since sperm reported in mL and not microL you have to multiply by 1000

Question 23

What are some reasons for low sperm concentration?

Answer 23

anatomical defects, short periods of abstinence, loss of first portion of ejaculate, and low or absent fructose

Question 24

How do you calculate sperm count?

Answer 24

sperm concentration x volume of ejaculate

Question 25

What is a normal sperm count?

Answer 25

> or equal to 40 million

Question 26

When and why is a sperm count performed?

Answer 26

after postvasectomy, collected at monthly intervals beginning 2 months after surgery; must have 2 monthly specimens with no sperm; presence of motile sperm indicates unsuccessful procedure; macroscopic results should still be normal

Question 27

How do you analyze morphology?

Answer 27

prepare slide and air dry, stain with wright's, giemsa, or papanicolaou; rate under oil immersion (1000x), count defective sperm and type of defect

Question 28

What is a normal percentage of normal sperm morphology?

Answer 28

normal sperm morphology=12-15% or greater normal sperm

Question 29

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

Answer 29

<5% normal sperm

Question 30

What is the teratozoospermia index (TZI)?

Answer 30

number of defects divided by total number of abnormal sperm; should be less than or equal to 1.6, helpful in predicting sperm function

Question 31

What would be the cause of abnormal morphology?

Answer 31

anatomical defects, physiological problems, infection, scrotal heating, and frequent ejaculations

Question 32

What two stains are useful in examining vitality?

Answer 32

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

Question 33

What is normal vitality?

Answer 33

> or equal to 50% or more alive in normal men

Question 34

What does leukocytes in ejaculate indicate?

Answer 34

should be less than 1 million/microL of seminal fluid otherwise indicate infection or inflammation

Question 35

What is measured in rape investigations?

Answer 35

look for motile sperm (24 hrs) or immotile sperm (3 days), acid phosphatase measurement, and PSA

Question 36

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

Answer 36

semen