Semen Analysis

Fertility testing; Postvasectomy semen analysis; Forensic analysis (alleged rape).

Seminiferous tubules of the testes; Sertoli cells serve as nurse cells for developing sperm.

Epididymis; Sperm become motile.

90 days; 74 days according to Graff.

Spermatozoa: 5%; Seminal fluid: 60–70%; Prostate fluid: 20–30%; Bulbourethral gland secretions: 5%.

Seminal vesicles; Provides nutrients and fluid for sperm; Rich in fructose for sperm motility.

Acidic fluid containing ACP, zinc, citric acid, and other enzymes; Responsible for coagulation and liquefaction.

Secrete thick alkaline mucus; Neutralizes acidity from prostatic secretions and the vagina.

2–3 days but not more than 7 days; Increased volume and decreased sperm motility.

The first and last portions have different compositions, and losing either portion affects semen analysis results.

Decreased sperm count; Increased pH; Specimen will not liquefy.

Increased sperm count; Decreased pH; Decreased volume; Specimen will not clot.

Masturbation (best method); Coitus interruptus (withdrawal method); Condom method.

Non-lubricant-containing rubber or polyurethane condom.

Within 1 hour of collection; Room temperature.

Time of specimen collection; Time of specimen receipt; Time of liquefaction.

After liquefaction; Usually 30–60 minutes.

Deficiency in prostatic enzymes.

Amylase; Bromelain; α-chymotrypsin.

37°C.

Gray-white and translucent; Musty or bleach odor.

Infection due to increased WBCs.

Increased RBCs or blood.

Urine contamination; Medication; Increased abstinence (increased flavin).

Normal: 2–5 mL; Increased: Prolonged abstinence; Decreased: Infertility or incomplete collection.

Normal: Pours in droplets; Abnormal: Threads longer than 2 cm.

Decreased sperm motility.

0 = Watery; 4 = Gel-like; May also be reported as low, normal, or high.

7.2–8.0; Within 1 hour of ejaculation.

Increased pH: Infection; Decreased pH: Increased prostatic fluid.

Greater than 20 million sperm/mL; Normal range: 20–160 million sperm/mL.

Improved Neubauer counting chamber; Makler counting chamber.

Dilution: 1:20; Diluents: Formalin, sodium bicarbonate (NaHCO₃), saline, distilled water, and cold tap water (alternative).

To immobilize sperm.

Uses undiluted semen specimen; Uses heat to immobilize sperm.

Load both sides; Allow to settle for 3–5 minutes; Count both sides.

Counts should agree within 10%.

Greater than 40 million sperm/ejaculate.

Sperm count = Sperm concentration × Specimen volume.

40 million sperm/ejaculate.

Place a drop of semen on a slide; Cover with a coverslip; Allow to settle for 1 minute; Observe in 20 HPF.

More than 50% motile within 1 hour; Quality score greater than 2.0.

4.0: Rapid straight-line motility; 3.0: Slower speed with some lateral movement; 2.0: Slow forward progression with noticeable lateral movement; 1.0: No forward progression; 0: No movement.

Progressive motility (PM): Sperm moving linearly or in a large circle; Nonprogressive motility (NP): Sperm moving without progression; Immotility: No movement.

Sperm concentration; Morphology; Velocity; Trajectory (direction of motion).

Routine criteria: More than 30% normal forms; Kruger's strict criteria: More than 14% normal forms.

Head; Neck; Tail.

45°.

Papanicolaou's stain (stain of choice); Wright's stain; Giemsa stain.

Length: 5 µm; Width: 3 µm; Oval-shaped.

Covers ½ of the head; Covers ⅔ of the nucleus.

Poor ovum penetration.

Midpiece: Contains mitochondria; Neck: 7 µm; Tail: 45 µm.

Poor motility.

The sperm tail length already includes the neck length; The neck is the thickest part of the tail.

Hardening of the veins that drain the testes; Most common cause of male infertility.

Tapered head.

Modified Blom's test; Within 1 hour of ejaculation.

Eosin and nigrosin; Living sperm: Unstained, bluish-white; Dead sperm: Red.

50% living sperm.

Within 2 hours of collection or frozen to prevent fructolysis.

Resorcinol test (Seliwanoff's test); Positive: Orange-red color.