They provide only 5% of the semen volume.
It is a thick, alkaline mucus that helps to neutralize acidity from the prostate secretions and the vagina’s bacteria flora.
Color | Clinical Significance |
---|---|
gray-white, translucent | normal |
white turbidity | WBCs, infection within the reproductive tract |
red coloration | RBCs |
yellow | urine contamination, prolonged abstinence, medications |
The recommended method is the Neubauer chamber count.
The counts should agree within 10%, and the average of the two counts is used in the calculation.
Numerical Grade | Alphabetical Grade | WHO Criteria |
---|---|---|
4.0 | a | rapid, straight-line motility |
3.0 | b | slower speed, some lateral movement |
2.0 | b | slow forward progression, noticeable lateral movement |
1.0 | c | no forward progression |
0 | d | no movement |
Sperm morphology is evaluated with respect to the structure of the head, neckpiece, midpiece, and tail.
The normal sperm has an oval-shaped head approximately 5 μm long and 3 μm wide and a long, flagellar tail approximately 45 μm long.
The enzyme-containing acrosomal cap located at the tip of the head is critical for ovum penetration.
The acrosomal cap should encompass approximately half of the head and covers appproximately two-thirds of the sperm nucleus.
The neckpiece attaches the head to the tail and the midpiece.
The midpiece is the thickest part of the tail because it is surrounded by a mitochondrial sheath that produces the energy required by the tail for motility.
Sperm morphology is evaluated from a thinly smeared, stained slide using Wright’s, Giemsa, or Papanicolaou stain under oil immersion and are stable for 24 hours.
At least 200 sperm should be evaluated and the percentage of abnormal sperm reported.
Abnormalities in head structure include double heads, giant and amorphous heads, pinheads, tapered heads, and constricted heads.
Abnormal sperm tails are frequently doubled, coiled, or bent.
An abnormally long neckpiece may cause the sperm head to bend backward and interfere with motility.
Additional parameters include measurement of head, neck, and tail size, size of the acrosome, and the presence of vacuoles and require the use of a stage micrometer or morphometry; however, it is not required in routine examinations but recommended by the WHO.
Normal values for sperm morphology vary from greater than 30% normal forms when using routine criteria to greater than 14% normal forms when using strict criteria.
For round cells, they are calculated using the formula C = (N x S)/100, where N equals the number of spermatids or neutrophils counted per 100 mature sperm, and S equals the sperm concentration in millions per milliliter.
Specimens can be screened for the presence of fructose using the resorcinol test that produces an orange color when fructose is present.
Quantitatively, it can be determined using spectrophotometric methods.
Specimens for fructose levels should be tested within 2 hours or frozen to prevent fructolysis.
Low to absent fructose levels indicate a low sperm concentration caused by lack of the support medium produced in the seminal vesicles.
Analyte | Normal Values |
---|---|
neutral α-glucosidase | ≥20 mU/ejaculate |
zinc | ≥2.4 μmol/ejaculate |
citric acid | ≥52 μmol/ejaculate |
acid phospatase | ≥200 units/ejaculate |
The concern is the presence or absence of spermatozoa.
Specimens are routinely tested at monthly intervals, beginning at 2 months post-vasectomy and continuing until two consecutive monthly specimens show no spermatozoa.