031108

SEMEN ANALYSIS

increase:
incomplete liquefaction
prostate dysfunction
chronic inflammation

Seminal Fluid Analysis

- evaluate infertility
- follow-up vasectomy

Volume

Seminal fluid
- composite solution from reproductive organs
testis
spermatozoa (<5%)
formed in seminiferous tubules
seminal vesicle
yellow alkaline fluid (60%)
high fructose content
nutritive medium (sperm becomes
motile)
prostate gland
milky fluid (20%)
acidic (pH 6.5)
proteolytic enzymes acid
phosphatase (for coagulation)
bulbourethral glands
alkaline mucus
neutralize acidity (prostate, vagina)
Sperm Collection
- ejaculation 3 fractions:
1st fraction
2 fraction
nd

clear viscid fluid

lubrication
spermatozoa
prostate secretion (enzymes)
mucoid secretion (seminal vesicles)

3rd fraction
- sexual abstinence:
3 to 5 days
<3
dec. sperm conc.
>7
dec. motility (dec. fluid content)
- manner of collection:
masturbation
clean wide mouth container
coitus
non-spermicidal condom
NB: coitus interruptus not acceptable
withdrawal method: 1st and parts of
2nd fraction will be lost
sent to lab within 1 hour after collection
report:
name
period of abstinence
date/time of collection
Macroscopic Examination:
Appearance
grey opalescent appearance (translucent, homogenous);
forms a coagulum (jelly-like grains)
musty odor
liquefaction time:
within 20 mins
30-60 mins
due to enzymes - lyse the coagulum
yellow color
urine contamination
prolonged abstinence
drugs (TB drugs, vitamin-containing drugs)
clear
low sperm conc.
red
hematospermia
turbidity
mucous streaks
WBC
Viscosity
fluid consistency (must be watery, less viscous)
procedure:
placed in pipette
allow to drop by gravity
normal form small droplets
abnormal form threads

normal volume:
1.5-5.0 mL
decrease value:
obstruction
accessory sex gland abnormality
incomplete specimen collection (withdrawal)
associated with infertility
increase value:
assoc with varicocoele ( heat - dilated veins)
sexual abstinence
Chemical Examination:
pH
NV:

>7.0
7.2-8.0
acid secretion
prostate
alkaline secretion
seminal vesicle
dec. value:
inc. prostate fluid
agenesis of seminal vesicle
inc. value:
infection
Microscopic Examination:
Sperm Count
determined by Hemocytometer method
1:20 dilution (WBC pipette)
diluent: (to immoblize the sperm)
NaHCO3
formalin
tap water
count 4 large WBC squares
multiple by 50,000
NV:
60-150 X 106 / mL
<20 x 106 / mL
subfertile
<4 x 106 / mL
infertile
(get average if 2 values differ by only 10%, if >10% - repeat)
Sperm Motility
perform wet smear
evaluate 200 spermatozoa
grading:
grade 0
no movement
grade I
minimal forward progression
grade II
poor to fair activity
grade III good activity with tail movement
visible
grade IV full activity with tail movement
difficult to visualize
N.V.:
50% motile
Sperm Morphology
evaluated by differential counts of normal and abnormal
spermatozoa
abnormalities: (head, tail - most common, neck)
head
associated with poor ovum penetration
tail
associated with motility
stains:
Wrights, Giemsa, Papanicolau
evaluate 200 spermatozoa
NV:
>70% normal, mature spermatozoa

acrosomal cap - contain enzymes

smudge head
winged sperm
big head
small head
notched neck
Table II. Nomenclature form semen variables (WHO 1992)
normozoospermia
20x106 spermatozoa/ml or more
oligozoospermia
sperm concentration fewer than
20x106/ml
asthenozoospermia
fewer than 50% spermatozoa with
forward progression (GRADE I/II) or
fewer than 25% spermatozoa with
GRADE I movement
teratozoospermia
fewer than 30% spermatozoa with
normal morphology
oligoasthenoteratozoospermia
signifies disturbance of all three
variables (combination of only two
prefixes can be used)
azoospermia
no spermatozoa in the ejaculate
aspermia
no ejaculate
-ENDThe best thing about the future is that it only comes one day at a time.