Body Fluids- Seminal Analysis

Seminal fluid

Composite fluid containing spermatozoa and secretions from male accessory glands

Primary purpose of seminal fluid

Provide nutrients, transport medium, and protection for sperm

Clinical indications for semen analysis

Infertility evaluation, post-vasectomy testing, forensic analysis

Sperm production site

Seminiferous tubules of the testes

Function of epididymis

Storage and maturation of sperm

Epididymis contribution to semen volume

Approximately 5 percent

Seminal vesicles

Primary contributors to semen volume

Seminal vesicle contribution

Approximately 60 percent of semen volume

Key substance from seminal vesicles

Fructose

Prostate gland contribution

Approximately 20 to 30 percent of semen volume

Prostatic secretions

Citric acid, zinc, acid phosphatase, proteolytic enzymes

Function of prostatic enzymes

Coagulation and liquefaction of semen

Bulbourethral glands

Produce thick alkaline mucus

Function of bulbourethral secretions

Neutralize urethral acidity

Preferred specimen collection method

Masturbation into a sterile container

Abstinence period before collection

Approximately 3 days

Effect of prolonged abstinence

Increased volume with decreased motility

Specimen rejection criteria

Incomplete sample or condom collection

Time requirement for analysis

Within 1 hour of collection

Normal liquefaction time

30 to 60 minutes after ejaculation

Normal semen appearance

Turbid and translucent

Coagulation of semen

Occurs immediately after ejaculation

Liquefaction of semen

Occurs due to prostatic proteolytic enzymes

Delayed liquefaction

delayed- Associated with prostatic dysfunction

Increased viscosity

inc visc- Associated with infection or inflammation

Decreased viscosity

May indicate seminal vesicle dysfunction

Normal semen volume

2 to 5 milliliters

Low semen volume

Seen in ejaculatory duct obstruction or seminal vesicle dysfunction

High semen volume

Seen with prolonged abstinence

Normal semen pH

7

2 to 8

0

Decreased semen pH

pH- Associated with prostatic dysfunction

Increased semen pH

inc pH- Associated with infection or inflammation

Sperm concentration

Number of sperm per milliliter of semen

Normal sperm concentration

Greater than 20 million per milliliter

Low sperm concentration

Suggests oligospermia

Azoospermia

Complete absence of sperm

Total sperm count

Total sperm per ejaculate

Normal total sperm count

Approximately 40 million per 2 milliliter ejaculate

Sperm motility

Ability of sperm to move forward

Normal sperm motility

30 to 90 percent motile

Decreased sperm motility

Associated with tail defects or antisperm antibodies

Immotile sperm

Seen in structural defects or antibody interference

Sperm morphology

Assessment of sperm size and shape

Normal sperm morphology

Oval head with acrosome and long tail

Acrosome function

Enables penetration of the ovum

Morphology staining methods

Wright, Giemsa, or Papanicolaou stain

Morphology assessment

200 sperm counted and reported as percent abnormal

Abnormal sperm morphology

Associated with infertility

Sperm viability

Percentage of living sperm

Viability testing method

Eosin-nigrosin stain

Viability stain interpretation

Live sperm remain unstained, dead sperm stain red

Normal sperm viability

At least 75 percent viable

Seminal fructose

Primary energy source for sperm motility

Normal seminal fructose

Greater than or equal to 13 micromoles per ejaculate

Low seminal fructose

Suggests seminal vesicle obstruction or absence

Timing of fructose testing

Within 2 hours to prevent fructolysis

Leukocytospermia

Increased white blood cells in semen

Leukocytospermia threshold

Greater than 1

0 × 10⁶ WBC per milliliter

Clinical significance of leukocytospermia

Indicates infection or inflammation

Common organisms in semen infection

Chlamydia trachomatis, Mycoplasma hominis, Ureaplasma urealyticum

Antisperm antibodies

Antibodies that impair sperm motility or function

Blood-testes barrier

Prevents antibody exposure to sperm

Mixed agglutination reaction

Test for antisperm antibodies using cervical mucus

Immunobead test

Uses antibody-coated beads to detect antisperm antibodies

Neutral alpha glucosidase

NAG- Marker of epididymal function

Decreased alpha glucosidase

Seen in epididymal disorders

Zinc in semen

Marker of prostatic function

Citric acid in semen

cit- Marker of prostatic secretory activity

Acid phosphatase in semen

Decreased in prostatic dysfunction

Agglutination of sperm

Clumping of sperm cells

Cause of sperm agglutination

Antisperm antibodies or infection

Clinical significance of agglutination

Reduces sperm motility and fertility

Post-vasectomy semen analysis

Evaluates success of vasectomy

Post-vasectomy criteria

Absence of sperm after centrifugation

Confirmation of vasectomy success

Two consecutive negative specimens

Correlation of semen analysis and infertility

Multiple abnormal parameters reduce fertility potential

Low motility with normal count

Suggests functional sperm defect

Normal semen parameters

Do not guarantee fertility