Semen Analysis

Semen is a grey opalescent fluid which is formed at ejaculation. It is composed of suspension of spermatozoa in seminal plasma.
. Semen is made up of the secretion of all the accessory glands of the male genital tract: (Testes 5%, Seminal vesicle 46-48%, Prostate 13-33%, Bulbourethral gland 2-5%). Semen analysis report include: Physical examination Microscopic examination Biochemical tests 1. PHYSICAL PROPERTIES OF SEMEN normal value VOLUME 2-5 ml/ejaculation
abnormal Aspermia Oligospermia Hypospermia Hyperspermia
COLOUR
greyish white -It is opalescent due to its high content of protein and the presence of more than 60 million sperms /ml
pale yellow discoloration
pink bright red very bright yellow alteration of pH
pH
7.3-8.1 * recorded on fresh semen by using pH paper with a range of 7-9 VISCOSITY which allows semen to be poured drop by drop out of the container * measured the time taken by one drop to leave the standard pipette SPECIFIC 1.028 GRAVITY
total absence of ejaculation (rare) reduced volume of seminal fluid seminal fluid volumeis less than 2 ml increased volume of semen above 10 ml (rare) urine * easily detected by the consistency of the semen and the urineferous odour blood (haematospermia) traces of fresh blood large amounts of blood deep jaundice (bilirubin) inflammatory conditions of prostate or seminal vesicles
2. MICROSCOPIAL EXAMINATION normal value SPERM COUNT 20 million/ml = the number (about 60 of sperms in millions/ejaculation) an ejaculation *obtained by multiplying the sperm concentration by the volume MOTILITY after 1 hour there must be = percentage >80% active sperms of sperms in * performed soon after the the seminal production of the sample & fluid which are is repeated after 1,2,3 and 6 highly active hours after semen production
no spermatocytes (male sterility) Oligozoospermia <20 million/ml (<50million/ejaculation) Polyzoospermia may reach 350 million/ejaculation Grades of motility (WHO) ARapid forward progress motility BSlow or sluggish progressive motility CNonprogressive motility DImmotility the cutoff value for normal is - 50% grade A+B or - 25% grade A motility Asthenospermia sperm motility less than the WHO cutoff levels MORPHOLOGY normally, the sperm count contains <20% abnormal forms e.g. bitailed, short tailed, 2 heads, etc Non-sperm cells RBCs WBCs epithelial cells pus cells
abnormal Azoospermia
spermatocytes (germinal cells) VIABILITY
- normally, there are no RBCs - if present, this indicates haematospermia - normally there are very little number of WBCs - increase in cases of inflammation always present in semen - zero to few number -presence of large numbers of these cells indicates inflammation - usually present in normal semen, but few in number
- when the motility is reported as less than 5% to 10%, viability testing is recommended because profoundly low motility may indicate dead sperm (necrospermia) 1. the most common viability assessment involves staining with Eosin Y followed by counter staining with Nigrosin the viable sperm with its intact cell membrane will not take up the dye and will remain unstained 2. Hypo-osmotic swelling test (HOST) - an alternative method to assess sperm viability - based on the principle that viable sperm have intact cell membranes exposure of the sperm to hypo-osmotic fluid will cause water to flow into the viable cells seen as swelling of the cytoplasmic space & curling of the sperm tail non-viable sperm with nonfunctional cell membranes will not exhibit this effect because they cannot maintain an osmotic gradient
3. BIOCHEMICAL TESTS
FRUCTOSE properties/fx - secreted from the seminal vesicle (150-650 mg%) - secreted for nutrition of sperm cells uses of tests/abnormal condition - disappears in cases of: 1. absence of seminal vesicle 2. obstruction of ejaculatory duct 3. inflammation of seminal vesicle - decreased in case of testosterone deficiency fructose is used as fertility test using Seliwanoffs test - secreted from the prostate the test is used as: 1. a marker of prostatic functions 2. in forensic laboratories as a test for the presence of semen approximately 10% of infertile men will present with antisperm antibodies (ASA) it has been suggested to be tested routinely in all men undergoing infertility work-ups low acrosin activity has been associated with low sperm density, motility, and poor normal morphology necessary for - chromatin stability and decondensation - headtail detachment during fertilization - secreted by the epididymis - low L-carnitine levels are found in - concentrated in the seminal plasma at oligoasthenozoospermic men up to 10 times the serum levels - has a role in sperm maturation - play a role in sperm maturation in the - used to distinguish nonobstructive from epididymis obstructive azoospermia - used as a specific marker for epididymal function * a cutoff value of 12 mIU/mL distinguishes ductal obstruction from primary testicular failure
ACID PHOSPHATASE
ANTISPERM ANTIBODY TEST ACROSIN ZINC
L-CARNITINE
ALPHA GLUCOSIDASE
NORMAL SEMEN PARAMETERS test LIQUEFACTION MORPHOLOGY MOTILITY Ph SPERM COUNT VOLUME WBCs Precautions and steps of semen sample collection

normal value within 20 minutes > 70% normal,mature spermatozoa > 60% > 7.0 (average 7.7%) 60-150 million/ml 1.5-5.0 ml < 1million/ml
There should be 2 to 7 days of sexual abstinence before collection The duration of abstinence should be constant, if possible Two separate samples at least 7 days apart should be analyzed It is best to collect the specimen in a clean (not necessarily sterile), wide-mouthed jar It is important that the entire specimen be collected, because the initial fraction contains the greatest density of sperm Ideally, collection should take place in the location where the analysis will be performed The degree of sperm motility should be determined as soon as possible after liquefaction, which usually occurs 15 to 20 minutes after ejaculation Semen should not be exposed to marked changes in temperature, and if collected at home during cold weather, the specimen should be kept warm during transport to the laboratory In order to allow liquefaction and mixing, semen is placed in a 370 C gently shaking incubator for 30 minutes The semen sample should be examined within 1 hour of production and receipt in the laboratory

Semen Analysis

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Semen is a grey opalescent fluid which is formed at ejaculation. It is composed of suspension of spermatozoa in seminal plasma.

abnormal Aspermia Oligospermia Hypospermia Hyperspermia

pale yellow discoloration

pink bright red very bright yellow alteration of pH

spermatocytes (germinal cells) VIABILITY

ANTISPERM ANTIBODY TEST ACROSIN ZINC

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