1 URINALYSIS AND BODY FLUIDS (SEMINAL FLUID) LECTURE Dr. Essam H. Jiffri

2 SPERM COUNT - Fertilization is accomplished by one spermatozoa. - Normal values are commonly listed as 20 to160 million sperm per milliliter, with counts between 10 and 20 million per milliliter considered borderline.

3 SPERM COUNT - The sperm count is performed in the same manner as blood and CSF counts; that is by diluting the specimen and counting the cells in a Neubauer chamber. - The amount of the dilution and the number of squares counted vary among laboratories.

4 Two frequently used methods dilute the specimen 1:20 and count the sperm in either the five RBC squares or in two large WBC squares.

5 SPERM COUNT - When the five RBC squares are used, the number of sperm counted is multiplied by 1,000,000 to calculate the number of sperm per milliliter. - If the two WBC squares are used, the count is multiplied by 100,000 to achieve the same result.

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7 SPERM COUNT - The traditional diluting fluid contains sodium bicarbonate and formalin, which immobilize and preserve the cells, good results can also be achieved using tap water.

8 Motility - Laboratory evaluation of sperm motility is performed by examining the undiluted specimen microscopically and determining the percentage of sperm showing active motility.

9 Motility - Approximately 25 high-power field should be examined. - A minimum motility of percent with a quality of fair (2.0) is considered normal for specimens tested within the 3-hour time period.

10 Morphology - The presence of a normal number of sperm that are non-motile will produce infertility, and the presence of sperm that are morphologically incapable of fertilization also will result in infertility.

11 Morphology - Sperm morphology is evaluated with respect to both head and tail appearance. - The normal sperm has an oval head measuring approximately 3 x 5 µm and a long tapring tail.

12 Morphology - Abnormality in head structures are associated with poor ovum penetration and include double heads, giant and morphous heads, pin heads, tapering heads, and constricted heads.

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14 Morphology - Motility is impeded in sperm with double or coiled tails. - Immature sperm (spermatids) also may be present and must be differentiated from white blood cells. - They are more spherical than mature sperm and may or may not have tails.

15 Morphology - Sperm morphology should be reported from a stained specimen examined under oil immersion, the recommended stain is the Papanicolaou, and if this is not available acceptable results can be obtained by using hematoxylin, crystal violet, or Giemsa stains.

16 Morphology - A specimen that contains less than 30 percent abnormal forms is considered normal. - Additional tests may be requested, the most common are tests for sperm viability, seminal fluid fructose level, and sperm agglutinins.

17 Morphology - Viability is tested by mixing the specimen with an eosin-nigrosin stain and examining microscopically for dead cells that stain red against a purple background. - Living cells are not infiltrated by the eosin dye and remain a bluish-white color.

18 Morphology - It is not common to find viable sperm in a postvasectomy patient, and care should be taken to overlook even a single sperm. - Specimens are routinely tested at monthly intervals beginning at 2 months postvasectomy and continuing until 2 consecutive monthly specimens show no spermatozoa.

19 Normal values for Semen Analysis ________________________________________ Volume2-5 ml ViscosityPours in droplets pH Count million/ml Motility> 50-60% within 3 hours Quality > 2.0 of fair Morphology< 30% Abnormal forms ________________________________________