CM - Semen

1. Epididymis

2. Seminal vesicles

3. Prostate gland

4. Bulbourethral glands

[SEMEN PHYSIOLOGY]

4 Fractions of Semen

that are contributed by the testes

Testes

[SEMEN PHYSIOLOGY]

This is referred to as the

pair glands in the scrotum

Seminiferous tubules

[SEMEN PHYSIOLOGY]

This is referred to as coiled tubules

found within the testes which is responsible for

SPERM SECRETION

LOW SCROTUM TEMPERATURE 🡫

for "optimal" sperm development

[SEMEN PHYSIOLOGY]

What is the purpose of the

external location of scrotum?

Seminiferous Epithelium

[SEMEN PHYSIOLOGY]

Where is the

PRODUCTION of spermatozoa

occurs?

Primordial Germ Cells (PGC)

[SEMEN PHYSIOLOGY]

This is referred to as the "primary"

undifferentiated stem cell that will differentiate

towards gametes (sex organisms):

spermatozoa or oocytes

Spermatozoa

[SEMEN PHYSIOLOGY]

What is produced within the

seminiferous epithelium?

Produce ANDROGEN and TESTOSTERONE

under the control of pituitary luteinizing hormone (LH)

[SEMEN PHYSIOLOGY]

Primary Function of

Leydig cells (Interstitial cells)

Provides SUPPORT and NUTRIENTS

for germ cells as they undergo spermatogenesis

[SEMEN PHYSIOLOGY]

Primary Function of

Specialized Sertoli cells (Epithelial cells)

PERISTALSIS (muscle contractions)

to propel sperm through the seminiferous tubules

[SEMEN PHYSIOLOGY]

Primary Function of

Seminiferous Smooth Muscle

1. Spermatocytogenesis

2. Spermiogenesis

[SEMEN PHYSIOLOGY]

2 PHASES of SPERMATOGENESIS

GERM CELL

divides into

🡫

4 Precursor Gametes

known as

SPERMATIDS - IMMATURE SPERMS

[SEMEN PHYSIOLOGY]

Explain process of

SPERMATOCYTOGENESIS

SPERMATIDS

(IMMATURE SPERMS)

🡫 maturation

🡫 differentiation

MATURE SPERMS

remains in epididymis

until ejaculation

[SEMEN PHYSIOLOGY]

Explain process of

SPERMIOGENESIS

90 days

[SEMEN PHYSIOLOGY]

How long does spermatogenesis takes?

(1) EPIDIDYMIS

🡫

(2) VAS DEFERENS (Ductus deferens)

🡫 mixed with fluid from (3) seminal vesicle

(4) EJACULATORY DUCT

🡫 penetrates to

(5) PROSTATE GLAND

🡫

(6) URETHRA

🡫

receives substances

from (7) BULBO-URETHRAL GLANDS

[SEMEN PHYSIOLOGY]

Pathway of Sperm Ejaculation

(7)

Secretes ALKALINE FLUID

with fructose, flavin (coenzyme), and prostaglandins

[SEMEN PHYSIOLOGY]

Primary Function of

Seminal Vesicles

1. Acid Phosphatase

2. Citric Acid

3. Zinc

4. Fructose

5. Fibrinogen-like coagulable proteins

[SEMEN PHYSIOLOGY]

Components of Seminal fluid (5)

NEUTRALIZE the ACID

in the female reproductive tract

[SEMEN PHYSIOLOGY]

What is the purpose of alkaline fluid in sperm?

ENERGY for the sperm motility

[SEMEN PHYSIOLOGY]

What is the purpose of fructose in sperm?

Facilitates

SEMEN CLOTTING

[SEMEN PHYSIOLOGY]

What is the purpose of enzyme in sperm?

Provides

MOTILITY and VIABILITY

for the sperm

[SEMEN PHYSIOLOGY]

What is the purpose of prostaglandins in sperm?

Flavin

[SEMEN PHYSIOLOGY]

Which is responsible for the

gray appearance of semen?

1. Secretes CITRATE as ENERGY

for sperm motility

2. Secretes ENZYMES to BREAK DOWN

semen clot in the female reproductive tract

[SEMEN PHYSIOLOGY]

Primary Function of

Prostate Gland

(2)

1. Acid phosphatase

2. Citric Acid

3. Zinc

4. Proteolytic enzyme

[SEMEN PHYSIOLOGY]

Components of Prostate Fluid

(4)

COAGULATION and LIQUEFACTION

of the semen

[SEMEN PHYSIOLOGY]

What is the purpose of proteolytic enzyme in semen?

Secretes MUCUS-CONTAINING VISCOUS FLUID

[SEMEN PHYSIOLOGY]

Primary Function of

Bulbourethral Gland

1. LUBRICANT

2. NEUTRALIZE the ACID

from prostate sections and vagina

[SEMEN PHYSIOLOGY]

What is the purpose of alkaline mucus in semen?

(2)

Seminal Fluid

[SEMEN PHYSIOLOGY]

Which composition of semen serves as a

"transport medium" for sperm?

1. Seminal fluid

2. Prostate fluid

3. Spermatozoa

4. Bulbourethral glands

[SEMEN PHYSIOLOGY]

Semen Composition (4)

60 - 70%

[SEMEN PHYSIOLOGY]

Volume Percentage of Seminal fluid

in semen

20 - 30%

[SEMEN PHYSIOLOGY]

Volume Percentage of Prostate fluid

in semen

5%

[SEMEN PHYSIOLOGY]

Volume Percentage of Spermatozoa

in semen

5%

[SEMEN PHYSIOLOGY]

Volume Percentage of Bulbourethral Glands

in semen

VARIETY in the composition of the semen fractions

[SEMEN SPECIMEN COLLECTION]

What makes the proper collection

of a complete specimen "essential"

for accurate evaluation of male fertility?

FIRST PORTION

of the ejaculate

[SEMEN SPECIMEN COLLECTION]

Most of the sperm are contained in the ___________.

1. DECREASED sperm count 🡫

2. FALSELY INCREASED pH 🡩

3. NO LIQUEFACTION of the specimen

[SEMEN SPECIMEN COLLECTION]

What would happen if a "part" of the

first portion of ejaculate is missing?

1. DECREASED semen volume 🡫

2. FLASELY INCREASED sperm count 🡩

3. FALSELY DECREASED pH 🡫

4. NO CLOTTING of the specimen

[SEMEN SPECIMEN COLLECTION]

What would happen if a "part" of the

last portion of ejaculate is missing?

AFTER sexual abstinence

of at least 2 - 7 days

[SEMEN SPECIMEN COLLECTION]

When should the patient collect

their semen specimen?

1. HIGHER VOLUMES 🡩

2. DECREASED MOTILITY 🡫

[SEMEN SPECIMEN COLLECTION]

What would be the result of

semen collection in prolonged abstinence?

2 - 3 samples

[SEMEN SPECIMEN COLLECTION]

What is the number of specimen required to be collected that is recommended by WHO?

WARM STERIE GLASS

or

PLASTIC CONTAINERS

[SEMEN SPECIMEN COLLECTION]

What should the we provide

for patient semen collection?

in room provided by

the LABORATORY

[SEMEN SPECIMEN COLLECTION]

Where should the

semen specimen collection

take place?

Keep the specimen at ROOM TEMPERATURE

and deliver to the laboratory within 1 hour of collection

[SEMEN SPECIMEN COLLECTION]

What should be done if it's NOT possible

for the laboratory to provide a room for the patient's

semen specimen collection?

1. Px Name

2. Birth date

3. Period of sexual abstinence

4. Completeness of the sample

5. Difficulties with collection

6. Time of specimen collection

7. Specimen receipt

[SEMEN SPECIMEN COLLECTION]

What should be RECORDED

by the laboratory personnel

in semen specimen collected?

(7)

37'C

[SEMEN SPECIMEN COLLECTION]

What is the optimum temperature for the

semen specimen placed for awaiting analysis?

Masturbation

[SEMEN SPECIMEN COLLECTION]

What is the standard method for semen collection?

USE

NON-lubricant containing rubber

or polyurethane condoms

[SEMEN SPECIMEN COLLECTION]

If masturbation is NOT possible as a

method of collecting semen specimen, what is the alternative method?

contains

SPERMICIDES

[SEMEN SPECIMEN COLLECTION]

Why should we NOT accept ordinary condoms

for collecting semen specimen?

Coitus interruptus (withdrawal method)

[SEMEN SPECIMEN COLLECTION]

Which method of collecting semen

is NOT RELIABLE for semen analysis?

Due to LOSS OF FIRST PORTION

which contains HIGHEST NUMBER of spermatozoa

and

LOW pH of vaginal fluid

may affect sperm motility

[SEMEN SPECIMEN COLLECTION]

Why is coitus interruptus method considered

UNRELIABLE for semen analysis?

HIV

and

HEPATITIS VIRUS

[SEMEN SPECIMEN COLLECTION]

All semen specimens are potential reservoirs for?

Biohazard Waste

[SEMEN SPECIMEN COLLECTION]

Where do we discard semen specimens?

1. Bioassay

2. Intra-uterine Insemination (IUI)

3. In-vitro Fertilization (IVF)

[SEMEN SPECIMEN COLLECTION]

What is the indicated usage of

sterile materials and techniques

for SEMEN ANALYSIS? (3)

1. Macroscopic Examination

2. Microscopic Examination

[SEMEN ANALYSIS]

Semen Analysis for

Fertility Evaluation

(2)

1. Appearance

2. Volume

3. Viscosity

4. pH

5. Sperm concentration

6. Sperm Count

7. Motility

8. Morphology

[SEMEN ANALYSIS]

Parameters Reported

in SEMEN ANALYSIS

(8)

2 - 5 mL

[SEMEN ANALYSIS]

NORMAL VOLUME

for Semen Analysis

Pours in droplets

[SEMEN ANALYSIS]

NORMAL VISCOSITY

for Semen Analysis

7.2 - 8.0

[SEMEN ANALYSIS]

NORMAL pH

for Semen Analysis

> 20 million/mL

[SEMEN ANALYSIS]

NORMAL SPERM CONCENTRATION

for Semen Analysis

> 40 million/ejaculate

[SEMEN ANALYSIS]

NORMAL SPERM COUNT

for Semen Analysis

> 50% within 1 hour

[SEMEN ANALYSIS]

NORMAL MOTILITY

for Semen Analysis

> 2.0

or

a, b, c

[SEMEN ANALYSIS]

NORMAL QUALITY

for Semen Analysis

> 14% normal forms (strict criteria)

> 30% normal forms (routine criteria)

[SEMEN ANALYSIS]

NORMAL MORPHOLOGY

for Semen Analysis

< 1.0 million/mL

[SEMEN ANALYSIS]

NORMAL ROUND CELLS

for Semen Analysis

translucent

gray-white

[SEMEN ANALYSIS: APPEARANCE]

NORMAL COLOR

for Semen Analysis

musty odor

[SEMEN ANALYSIS: APPEARANCE]

NORMAL ODOR

for Semen Analysis

almost clear

[SEMEN ANALYSIS: APPEARANCE]

Semen Appearance

in LOW SPERM CONCENTRATION 🡫

PRESENCE of WBC

and

INFECTION in reproductive tract

[SEMEN ANALYSIS: APPEARANCE]

Indication of

INCREASED WHITE TURBIDITY 🡩

in Semen Analysis

Specimen culture

[SEMEN ANALYSIS: APPEARANCE]

What is performed prior

to continuing with the semen analysis?

White Blood Cells (WBCs) must be

DIFFERENTIATED from

IMMATURE SPERM or SPERMATIDS

[SEMEN ANALYSIS: APPEARANCE]

How is microscopic examination done

in semen analysis?

Leukocyte Esterase (LE)

reagent strip

[SEMEN ANALYSIS: APPEARANCE]

What chemical reagent test strip

may also be useful

to screen for presence of WBCs?

ABNORMAL PRESENCE of RBCs

[SEMEN ANALYSIS: APPEARANCE]

Indication of

VARYING AMOUNTS of RED COLORATION

in Semen Analysis

1. Urine Contamination

2. Prolonged abstinence

3. Medications

[SEMEN ANALYSIS: APPEARANCE]

Indication of

YELLOW COLORATION

in Semen Analysis

1. CLOTTED

2. LIQUEFY within 30-60mins

[SEMEN ANALYSIS: LIQUEFACTION]

NORMAL FRESH SEMEN SPECIMEN

Time of collection

[SEMEN ANALYSIS: LIQUEFACTION]

What is essential in evaluating

semen liquefaction?

Prostatic Enzyme deficiency

[SEMEN ANALYSIS: LIQUEFACTION]

Indication of

LIQUEFACTION TIME: 60mins

in Semen Analysis

ADD EQUAL VOLUME of:

- Dulbecco's phosphate-buffered saline

- proteolytic enzymes (alpha-chymotrypsin or bromelain)

[SEMEN ANALYSIS: LIQUEFACTION]

What should be done if after 2 hours

the specimen HAS NOT LIQUEFIED?

To INDUCE LIQUEFACTION and

PERFORM the rest of analysis

[SEMEN ANALYSIS: LIQUEFACTION]

What is the significance of adding

Dulbecco's phosphate-buffered saline and

proteolytic enzymes in Semen Analysis?

BROMELAIN DILUTION

of semen

[SEMEN ANALYSIS: LIQUEFACTION]

What must be significantly included in

calculating sperm concentration?

No Clinical Significance

[SEMEN ANALYSIS: LIQUEFACTION]

Indication of

JELLY-LIKE GRANULES (gelatinous bodies)

in liquefied semen of Semen Analysis

Mucus strands

[SEMEN ANALYSIS: LIQUEFACTION]

What could interfere with semen analysis if present?

1. POUR the specimen into a clean graduated cylinder

2. CALIBRATE in 0.1 mL increments

[SEMEN ANALYSIS: VOLUME]

How do we measure semen volume?

Prolonged abstinence

[SEMEN ANALYSIS: VOLUME]

Indication of

INCREASED SEMEN VOLUME 🡩

in Semen Analysis

INFERTILITY

due to improper functioning of one of the

semen-producing organs, primarily seminal vesicles

[SEMEN ANALYSIS: VOLUME]

Indication of

DECREASED SEMEN VOLUME 🡫

in Semen Analysis

Viscosity

[SEMEN ANALYSIS]

This refers to the "consistency" of the fluid

and may be related to specimen liquefaction

CLUMPED

and

HIGHLY VISCOUS

[SEMEN ANALYSIS: VISCOSITY]

Consistency of

INCOMPLETELTY LIQUEFIED

specimens

1. EASILY DRAWN to pipette

2. FORMS small discrete droplets that

DO NOT appear clumped or stringy

during fall of gravity from pipette

[SEMEN ANALYSIS: VISCOSITY]

Describe the

NORMAL VISCOSITY

of semen specimen

FORMS

≥ 2cm thread of droplets

[SEMEN ANALYSIS: VISCOSITY]

Describe a

HIGHLY VISCOUS

semen specimen

watery

[SEMEN ANALYSIS: VISCOSITY]

Semen Viscosity Rating: 0

gel-like

[SEMEN ANALYSIS: VISCOSITY]

Semen Viscosity Rating: 4

1. Low

2. Normal

3. High

[SEMEN ANALYSIS: VISCOSITY]

Reporting of Semen Viscosity

(3)

1. Sperm motility

2. Sperm concentration

3. Antisperm Antibody detection

4. Biochemical markers' measurement

[SEMEN ANALYSIS: VISCOSITY]

What are the tests "impeded" in semen specimen with

INCREASED VISCOSITY🡩 and

INCOMPLETE LIQUEFACTION?

GENTLY MIX

the sample container

[SEMEN ANALYSIS: VISCOSITY]

What can be done

to produce a "homogenous sample"

during liquefaction?

pH

[SEMEN ANALYSIS]

This indicates the "balance" between the pH values from the ACIDIC prostatic secretion

and ALKALINE seminal vesicles secretion

within 1 hour

after ejaculation

[SEMEN ANALYSIS: pH]

What is the optimum time

to viably measure semen pH?

Reproductive tract infection

[SEMEN ANALYSIS: pH]

Indication of an

INCREASED pH 🡩

in Semen Analysis

1. INCREASED prostatic fluid 🡩

2. OBSTRUCTION in ejaculatory duct

3. POORLY DEVELOPED seminal vesicles

[SEMEN ANALYSIS: pH]

Indication of a

DECREASED pH 🡫

in Semen Analysis

(3)

1. pH pad of urinalysis reagent strip

2. pH testing paper

[SEMEN ANALYSIS: pH]

Methods for pH testing

(2)

1. Days of sexual abstinence

2. Infection

3. Stress

[SEMEN ANALYSIS:

SPERM CONCENTRATION & SPERM COUNT]

Factors that affect

SPERM CONCENTRATION

(3)

10 - 20 million /mL

[SEMEN ANALYSIS:

SPERM CONCENTRATION & SPERM COUNT]

Borderline values of

Sperm Concentration