OTHER BODILY FLUIDS (Seminal fluid only) | MTAP 1 | FINALS

All of the following is the reason why we do semen analysis, except:

A. Advances in the field of andrology

B. Post-vasectomy

C. Primary test for bacteria

D. Forensic analysis

C

This is composed of contributions from several glands and structures

Semen

Sperm production occurs specifically in the?

Seminiferous tubules

Spermatogenesis is supported by what cells?

Sertoli cells

Spermatogenesis, this process takes up for how many days?

90 days

This is supported by Sertoli cells, and the process takes about 90 days

Spermatogenesis

Immature sperm develop motility and flagella in the?

Epididymis

This provides 60-70% of semen fluid

Seminal vesicles

This contributes 20-30% of semen fluid

Prostate gland

This produces acidic fluid

Prostate gland

Acidic fluid contains?

Acid phosphatase, citric acid, zinc, proteolytic enzymes

This helps in semen coagulation and liquefaction post-ejaculation

Acidic fluid

This provides about 5% of the total volume of semen fluid

Bulbourethral glands

What does bulbourethral glands secrete?

Alkaline mucus

This neutralizes vaginal acidity, essential for maintaining sperm motility and survival

Alkaline mucus

TRUE or FALSE.

A sperm can survive even without the alkaline mucus

False

Energy source for sperm motility

Fructose

Responsible for semen’s appearance and fluorescence

Flavin

This is involved in semen coagulation and liquefaction, ensuring sperm motility and viability post-ejaculation

Proteins and enzymes

This neutralize the acidic environment in the vagina, crucial for sperm survival

Alkaline pH

This portion of ejaculation contains most of the sperm

First portion

If this portion of semen collection is missed, it may result to:

Decreased sperm count

Falsely increased pH

Delayed liquefaction

First portion

This portion of ejaculation contributes to semen volume

Last portion

If this portion of semen collection is missed, it may result to:

Falsely increased sperm count

Falsely decreased pH

Failure of specimen to clot

Last portion

Before semen collection, patient should observe sexual abstinence for how many days

2-7 days

This may result to higher volume however decreased motility

Prolonged abstinence

Semen collection for fertility testing, WHO recommends collecting how many specimens

2-3 specimens for several weeks

Semen specimens should be delivered to the lab within?

1 hour of collection

Semen specimens should be kept at what temperature during transport?

Room temperature

Preferred collection method for semen is?

Masturbation into a sterile glass or plastic container

If masturbation is not possible for specimen collection, we must use?

Non-spermicidal condoms

Sterile techniques are mandatory, especially for procedures like?

Semen culture, intrauterine insemination, in vitro fertilization

Appearance of normal semen

White-gray, transluscent or opaque with musty odor

This appearance of semen may indicate presence of WBCs and suggests infection

Increased turbidity

This appearance of semen may indicate urine contamination, prolonged abstinence, or medication

Yellow

TRUE or FALSE.

Urine is toxic to your sperm

TRUE

This is when the sperm is expelled to the urinary bladder instead of the urethra which causes infertility

Retrograde ejaculation

If the patient is male, and there is presence of sperm in the urine:

A. We should report it

B. No need to report

C. Discard and ask the patient to recollect

D. Proceed to test sperm motility

Write E if there is no correct answer

A

Fresh semen is clotted or coagulated and should liquefy within how many minutes?

30-60 minutes

Failure for the semen specimen to liquefy may indicate what?

Prostatic enzyme deficiency

If after 2 hours, liquefaction does not occur, what should be added

Proteolytic enzymes

When adding proteolytic enzyme to the semen specimen, we should also add equal amounts of?

Physiologic dulbecco’s phosphate buffer saline

Semens volume normal range is at?

2-5mL

This is associated with prolonged abstinence (hyperspermia)

A. Increased volume

B. Decreased volume

A

This may indicate infertility or improper specimen collection (hypospermia)

A. Increased volume

B. Decreased volume

B

Normal semen pH is at?

7.2-8.0

Increased pH (>8) of semen specimen may indicate?

Infection

Decreased pH (<7.2) may indicate?

Increased prostatic fluid or ejaculatory duct obstruction

pH of the semen should be measured within?

1 hour of collection

The normal sperm concentration range is at?

>20-250 million sperm/mL

What is the borderline of sperm concentration?

10-20 million sperm/mL

How is the total sperm count computed?

Sperm concentration x semen volume

What is the normal total sperm count?

>40 million/ejaculate

Semen dilution should be in what ratio?

1:20

Semen is counted using?

Neubauer hemocytometer

In what are of the neubauer hemocytometer should we count sperm?

Both sides (upper and lower area)

These cells must be distinguished from mature sperm during analysis

Immature sperm (spermatids) and WBCs

A count of >1 million leukocytes/mL is indicative of?

Infection

A count of >1 million spermatids/mL is indicative of?

Disruption in spermatogenesis

What test is done to distinguish spermatids from WBCs?

Leukocyte esterase test

When leukocyte esterase is positive upon testing semen sample, what is present?

WBCs

When leukocyte esterase is negative upon testing semen sample, what is present?

Spermatids

Motility testing should be performed within?

1 hour of collection

TRUE or FALSE.

Semen sample should be well-mixed and liquefied before performing motility test

TRUE

How much sample is placed onto a 22×22 cover slip in performing motility test

10ul

How much sperm is examined per slide in motility testing?

200 sperm

TRUE or FALSE.

Concave microscope slide can also be used in performing motility test

TRUE

This is related to the fertility of a male

Sperm motility

This determines the functional capacity of the sperm

Motility test

Type of motility wherein sperm is moving linearly or in a large circle

Progressive motility

Type of motility wherein sperm is moving with absence of progression

Non-progressive motility

Type of motility wherein sperm has no movement

Immotility

A minimum of 50% motile sperm with a grade of 2.0 or more after 1 hour and at least 25% shows progressive motility is considered:

A. Normal

B. Abnormal

A

Part of the sperm that is oval shaped with an acrosomal cap/acrosome

Head

This helps your sperm head to digest the outer layer of ovum

Acrosin

The outer layer of the ovum is known as?

Zona pellucida

This is maternally inherited due to midpiece was separated during penetration

mtDNA

This contains mitochondria that power the sperm’s tail

Midpiece

The tail of the sperm is approximately how long?

45 um

This contains proteolytic enzyme that is responsible for the penetration of the sperm in the ovum

Acrosomal cap

What microscopy is used for morphology assessment of sperm

Oil immersion microscopy

For the morphology assessment of sperm, the slides are stained with?

Wright, giemsa, shorr, or papanicolaou stains

For the morphology testing of sperm, we should evaluate at least how many sperm for morphological abnormalities?

200 sperm

Any defects in sperm head can lead to?

Difficulty in penetration

Additional parameters for sperm abnormalities may be evaluated using?

Kruger’s strict criteria

Any defects in a sperm’s midpiece, neckpiece, or tail can lead to?

Difficulty in motility

For the normal morphology values in routine criteria, greater than ___ is considered normal

30% normal forms

For the normal morphology values in strict criteria, greater than ___ is considered normal

15% normal forms

This test is necessary when a semen sample has a normal concentration of sperm but significantly reduced motility

Sperm vitality

Sperm vitality is assessed by mixing the semen with?

Eosin nigrosin stain

Sperm vitality is assessed by counting the?

Percentage of dead cells

The dead cells in sperm vitality is stained with what color?

Red

Color of the live sperm remains?

Bluish-white

Living sperm in sperm vitality test should comprise ___ of the sample

50% or more

In sperm vitality, high numbers of dead cells suggests?

Epididymal pathology

In sperm vitality, live but immobile cells may indicate?

Flagellar defects

This is used to evaluate whether low sperm concentration is due to lack of seminal vesicle support

Seminal fluid fructose

This is used for qualitative detection, where an orange color indicates the presence of fructose

Resorcinol test

Quantitative testing for seminal fluid fructose uses what?

Spectrophotometry

Quantitative testing for seminal fluid fructose should show ___ as normal

More than or equal to 13 umol/ejaculate