Sperm Morphology and Motility Evaluation

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Questions and Answers

What is the size of the head of a sperm cell as described in the examination morphology?

4x6 µm

2x4 µm

3x5 µm (correct)

5x7 µm

What does a motility rating of 4.0 indicate according to the subjective evaluation of sperm motility?

Some lateral movement

Slow forward progression

Rapid and straight line movement (correct)

No forward progression

What should be noted when evaluating the morphology of sperm cells?

Presence of double heads, pin heads, or giant heads (correct)

Presence of cartilage

Presence of bone fragments

Presence of plant cells

How is a sperm sample typically diluted for counting?

1 to 20 with a traditional diluting fluid containing sodium bicarbonate and formalin Signup and view all the answers

What is the normal value for sperm count per mL?

20 – 160 million/mL Signup and view all the answers

What is the role of the middle piece of a sperm cell?

Provides energy Signup and view all the answers

What is the maximum acceptable percentage of abnormal sperm forms?

< 30% Signup and view all the answers

Which method provides objective evaluation of sperm motility but is only found in specialized labs?

CASA (computer assisted semen analysis) Signup and view all the answers

What is the primary function of fructose in the fluid produced by the seminal vesicles?

To provide energy for sperm motility Signup and view all the answers

Which component contributes the largest volume to seminal fluid?

Seminal vesicles Signup and view all the answers

Which gland is responsible for producing an acidic fluid that includes acid phosphatase?

Prostate gland Signup and view all the answers

What percentage of seminal fluid volume is contributed by the bulbourethral glands?

5% Signup and view all the answers

Why is it important to avoid lubricants or spermicides during specimen collection?

They may introduce contaminants Signup and view all the answers

Which of the following is a reason for testing seminal fluid?

To rule out male infertility Signup and view all the answers

What is the role of the prostate gland during ejaculation?

To aid in propelling sperm through the urethra Signup and view all the answers

What enzyme is specifically tested for in forensic analysis of seminal fluid?

Acid phosphatase Signup and view all the answers

What is the maximum number of days for sexual abstinence before semen analysis that could lead to higher volumes and decreased motility?

5 days Signup and view all the answers

What is the normal volume range for semen?

2 to 5 mL Signup and view all the answers

Which of the following indicates the likely presence of infection in seminal fluid during a semen analysis?

Increased white turbidity Signup and view all the answers

What should the sperm concentration in semen ideally be?

20-160 million / mL Signup and view all the answers

What does a red coloration in seminal fluid suggest?

Presence of RBCs Signup and view all the answers

What is the normal pH range of semen to help offset the vaginal environment?

7.2 - 8.0 Signup and view all the answers

How long after collection should a microscopic examination be done?

30-60 minutes Signup and view all the answers

What does incomplete liquefaction of semen indicate during analysis?

Possible abnormality Signup and view all the answers

Study Notes

Seminal Fluid

Seminal fluid is composed of four fractions contributed by the testes, epididymis, seminal vessels, prostate, and bulbourethral glands.
The mixing of these fractions during ejaculation is essential for a normal semen specimen.

Physiology of Seminal Fluids

Components of Semen:
- Secretions from Cowper's glands (pre-ejaculate, sialic acid, galactose, mucus) ~1-5%
- Secretions from the testes (spermatozoa) ~2-5%
- Prostate secretions (enzymes, acid phosphatase, zinc, citric acid, spermine, fibrinolysin, prostate-specific antigen) ~10-30%
- Secretions from seminal vesicles (prostaglandins, amino acids, fructose, citrate, enzymes, flavins, proteins, vitamin C) ~65-75%

Male Reproductive Tract

Diagram shows the organs involved in seminal fluid production. Organs include: testes, epididymis, seminal vesicles, prostate, bulbourethral glands, vas deferens, urethra, and penis.

Anatomy, Composition, and Formation

Testes: The source of sperm production.
Seminal Vesicles:
- Produce the majority (60-70%) of fluid present in semen.
- The fluid contains high levels of fructose and nutrients, metabolized by spermatozoa for energy to propel them through the female reproductive tract.
Prostate Gland:
- Located beneath the bladder and surrounds the urethra.
- Aids in propelling sperm through the urethra with contractions during ejaculation.
- Produces acidic fluid (20-30% of semen volume) with high concentrations of acid phosphatase, citric acid, zinc, and proteolytic enzymes, responsible for semen coagulation and liquefaction after ejaculation.
Bulbourethral Glands:
- Contribute about 5% of seminal fluid.
- Produce thick alkaline, mucus-like fluid neutralizing acids from prostate secretions and the vagina.

Seminal Fluids (Reasons for Testing)

Infertility Issues: Testing is often for ruling out male contribution to infertility.
Post-vasectomy: Testing is frequently done to confirm absence of sperm in two consecutive months after the procedure.
Forensic Analysis: Acid phosphatase is a key chemical test for identifying semen.

Specimen Collection

Sterile Container: Essential for semen collection to prevent contamination.
Abstinence: 2-3 days of sexual abstinence is recommended but no more than 5 days, because abstinence periods >5 days can result in lower volume and decreased motility.
Laboratory Collection: The ideal collection site for semen is within a medical laboratory. If not possible, specimens should be kept warm and delivered to the lab within 1 hour.
Time Records: Accurate time records for specimen collection are necessary.

Seminal Fluids

Spermatozoa: Produced in the testes and mature in the epididymis.
Fertility Testing: Two or three samples usually tested at 2-week intervals to identify abnormalities.

Semen Analysis

Macroscopic and Microscopic Examinations: Semen analysis for fertility evaluation combines both examinations.
Parameters: Reported parameters include appearance, volume, viscosity, pH, sperm concentration/count, motility, and morphology.

Seminal Fluids Appearance

Grey-white, translucent, characteristic musty odor. Increased white turbidity may indicate increased WBC and likely infection.
Red coloration indicates RBC presence which could indicate blood contamination.
Yellow coloration could indicate urine contamination, medications, or prolonged abstinence.

Volume, Viscosity, and pH

Volume: Normal semen volume ranges between 2 and 5 mL.
Viscosity: The consistency of semen, measured from a pipette tip. Normal semen should pour in droplets and not be stringy. Ratings from 0-4 based on water-like to gel-like (incomplete liquefaction may affect motility).
pH: Normal semen pH is 7.2-8.0. Alkaline to offset the acidity of the female vaginal environment.

Physical Characteristics: Liquefaction

Semen clots after ejaculation, then liquefies within 30 minutes. Persistence of clot is abnormal. Further evaluation is only conducted after liquefaction is complete.

Microscopic Examination

Examination should occur 30-60 minutes after liquefaction.
Motility: A vital quality of sperm evaluated using a hemocytometer. Sperm movement is examined in an undiluted sample with a high dry objective lens. Ratings are conducted from 0 (no movement) to 4 (rapid and straight line movement).
Sperm concentration: Normal values vary from 20 to 160 million/mL based on the analysis of 5 small squares on Neubauer hemocytometer used for RBC counting.

Examination: Motility

Subjective Evaluation and Rating Scale: From 0 to 4.0, with ratings used to describe sperm movement.
Normal Values (NV): 50% of sperm that demonstrate 2.0 or greater motility is considered normal within 1 hour of collection.
New Technology (CASA): Computer-assisted semen analysis is another type of technology.

Examination: Morphology

Shape and Structure of Sperm: Important assessments include the head (oval/egg, enzyme cap), middle piece (energy provider) and tail (length).
Staining and Evaluation: At least 200 sperm cells from a smear are evaluated using Wright's, Giemsa, or Papanicolaou stain.
Normal: 30% or less of abnormal forms.
Cells to Note: Also check for WBC, RBC, bacteria presence (indicative of infection). Round cells (neutrophils and immature sperm) should also be noted.

Microscopic Examination: Detailed Analysis

Sperm Count: Normal count is 20-160 million sperm/mL.
Dilution: 1:20 dilution is common in the traditionally used fluid that can include sodium bicarbonate and formalin for preserving the cells. Alternatively, saline or distilled water can be used. .
Counting Method: Count the sperm in 5 small squares on the Neubauer hemocytometer.

Example Calculation

52 cells x 20 (magnification) x 0.004 (microscope grid) results in 52.0 million cells/mL

Other Tests (Infertility)

Sperm Viability: Made from specimen mixed with eosin-nigrosin stain. Living cells appear blue-white under microscope, while dead cells appear red against a blue background.

Seminal Fluids (Forensic Analysis)

Acid Phosphatase: Highly sensitive, no other body fluid contains such high levels, useful (2500 units compared to other fluids like 5 units).
Other tests include ABO, HLA typing, and DNA analysis.
Visualization using UV light (semen fluoresces green/white.)

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Description

This quiz focuses on the essential aspects of sperm morphology and motility evaluation. It covers key concepts regarding sperm cell structure, sampling techniques, and seminal fluid composition. Participants will deepen their understanding of sperm analysis in a clinical context.