Semen Volume

NORMAL 2 mL to 5 mL
Composition of Seminal Fluid ABNORMAL
1. Acid Phophatase o No liquefaction beyond 60 minutes (suggest
2. Proteolytic enzymes infertility)
3. Citric Acid o Possible causes
4. Fructose Deficiency in prostatic enzymes
5. Potassium Abnormal function of seminal
6. Zinc vesicles
7. Spermine and Choline
Inhibits the growth of bacteria pH
NORMAL 7.5 to 7.8 (average 8.0)
Spermatogenesis Clinical Significance
Maturation phases completed in the epididymis o Acidic pH sluggish motility
Process takes approximately 74 days o Increased prostatic enzyme

Clinical Importance of the Analysis Specific Gravity

1. Fertility testing Normal 1.033
2. To check effectiveness of post vasectomy
3. To evaluate the quality of the semen and sperm Basis of Microscopic Analysis
4. For medico-legal (alleged rape cases) Motility
Clinical Significance: High concentration of Concentration
acid phosphatase Agglutination
5. For forensic application (DNA Analysis) Viability
6. For the establishment of dental of paternity and Penetration
ground on fertility
Sperm Motility Test
Handling and Methods of Collection Subjective Evaluation of Sperm Motility
1. Self-production or masturbation 1. High-motile, Low-motile, Non-motile
2. Emission after interrupted coitus 2. Progressive, Non-progressive and Non-motile
3. Condom collection 3. Strong linear progression, Linear progression
Non-lubricant rubber or polyurethane moderate, Slow linear progression, Non-progressive
Non-spermicidal and Non-motile

Physical Examination
Appearance Motility
NORMAL grey-white, translucent fluid; opaque Assessment of mobility after the liquefaction = 99%
Bloody or Red fluid 1 hour after collection = >50% or more actively motile
Yellow Important characteristic:
o Flavin o Moderate to rapid linear motility
o Urine contamination Abnormal in Motility
White turbidity o Non-motile or less than 50% on-motile
o Leukocytes o Increased immobility and clumps (suggest
o Infection agglutinins)
Clear
o Low sperm concentration 0 No motility
1 Movement, none forward
Odor 1+ Occasional movement of a few sperm
NORMAL musty, chlorox-like 2 Slow, undirected
ABNORMAL odorous in case of infections 2+ Slow, directly forward movement
3- Fast, but undirected movement
Viscosity and LIquefaction
3 Fast, directed forward movement
NORMAL
3+ Very fast forward movement
o Coagulates after ejaculation
4 Extremely fast forward movement
o Discrete droplets/liquefies after 30 60
minutes
Sperm Count in 4 WBC Squares
o Clinica Significance: droplets with threads of
Diluting Fluid
>2 cm HIGH VISCOSITY 1. Bicarbonate and Formalin
2. Normal Saline Solution
 3. Distilled water o Acrosomal cap for penetration into ovum
Elongated tailpiece (50 55 m L x 0.1 m neck to tip)
Sperm Sperm Count Abnormal:
Concentration Normal: Less than 20 or Three Distinct Regions
Normal: 40 million/ejaculation more than 250 a. Head
More than 20 million b. Neck (Midpiece)
million/mL c. Tail

Calculation for Sperm Concentration: Head Abnormalities

Acrosomal abnormalities
Total Sperm Count x 10 (depth) x 20 (Diluting factor) x 1000 Constricted head
4 (WBC Squares) Double-headed
= sperm/mL Flat-headed
Tapering head
Sperm Concentration Abnormalities Giant head
Oligospermia Pin head
<20 million/mL Nuclear abnormalities

Azoospermia Neck abnormality

Complete absence of sperm Excessive cytoplasmic membrane remaining

Necrospermia Tail Abnormalities

Dead/non-motile sperm Coiled tail
Cytoplasmic extrusion mass
Causes of Necrospermia: Bent neck
1. Chromosomal disorders Double-tailed
2. Ductal obstruction Multiple tails
3. Gonadotropin deficiency Variation in tail length
4. Hyalinization of the seminiferous tubules
5. Maturation arrest Leukocytes
6. Pituitary disorders >1,000,000/mL
7. Radiation and drugs o Inflammation of seminal vesicle
o Inflammation of prostate
Sperm Agglutination
Distinctly head-to-head or tail-to-tail clumping Staining Method for Viability Test
Clinical Significance:
Eosin stains dead sperm
o Presence of anti-sperm antibodies
Remain unstained live sperm
IgG
Nigrosin used for contrast
IgA
Normal - >75% live sperm
Test Procedures
o MAR (Mixed Agglutination Reaction)
System Penetration Test
Detects IgG antibodies a. Bovine Cervical Mucous Test
Determine the extent traveled by vanguard
Causes of Production of Sperm Antibodies
sperm
Disruption on blood-tests barrier
Normal = >30 mm
1. Vasectomy
2. Trauma
Chemical Analysis
3. Infection
pH
Production of an immune response to antigens
Nitrozine paper method
Production of antibodies to the female partner o Normal 7.2 to 7.8
o Acidic congenital aplasia of vasa deferens
Computer Assisted Sperm Analysis (CASA)
and seminal vesicles
Provides objective determination of:
a. Sperm velocity
Acid Phosphatase
b. Sperm trajectory
Clinical Significance
1. Evaluates secretory function of prostate
Sperm Morphology (Normal)
Normal levels = >200 units
Flattened oval head (4 5 m L x 2 3 m W)
2. Used as evidence in criminal/medico legal
o 65% nuclear material
cases
 3. Assessment of the secretory function
(prostate gland)

Hormones
Testosterone gonadotropin deficiency
LH gonadotropin deficiency
FSH gonadotropin deficiency and Hyalinization of
the seminiferous tubules

Microbiology
Urogenital infections account for 15% cases of male
infertility
Most common organisms
o Ureaplasma urealyticum
o Mycoplasma hominis
o Chlamydia trachomatis
o Herpes simplex
o Candida albicans