Semen analysis

Introduction Semen is a white or grey liquid, emitted from the urethra (tube in the penis) on ejaculation. The purpose of semen is purely for reproduction, as a vehicle to carry the spermatozoa (sperm) into the female reproductive tract. semen analysis It is measures the amount of semen, and determines the number and quality of sperm. Importance of semen analysis It is determines a reproductive problem that is causing infertility or a vasectomy has been successful.

Clinical significance Infertility Follow up vasectomy (ensure effectiveness) Forensic applications/studies (rape, paternity)

Composition of the semen Sperm cell (spermatozoa)- 5% Seminal vesicle fluid – 60% Accounts for most of the ejaculate Rich in flavin (gray color) Fructose (nutrient) Protein (coagulation)

Composition of the semen Prostatic fluid – 20 to 30% - milky, slightly acidic Citric acid enzymes e.g. acid phosphatase ( ACP): for liquefaction Zn (associated with disorders of prostate gland)

Composition of the semen 4- Epididymis: secretes a number of proteins into the tubule lumen that are essential for sperm motility

Function of semen Transport medium Activation of spermatozoal motility Provides nutritive substances Transport the spermatozoa to the female egg Provides enzymes necessary to penetrate the ovum wall & achieve fertilization

Specimen collection Abstinence? 2- Method : - At least 3 days (72 hours), not more 5 days 2- Method : The ejaculate is collected (by masturbation) in a clean, wide-mouthed container. Transport Keep at body temperature and must be examined within 1-2 hours after ejaculation.

Routine analysis Volume Color semen volumes between 1.5 mL and 6.5 mL are normal Color white or grey liquid

Routine analysis Liquefaction Time Allow the specimen to liquefy in 20 – 30 minutes and report the liquefaction time. Delayed liquefaction of semen more than one hour after ejaculation may indicate, an infection. Long liquefaction affect to motility of sperm cells.

Routine analysis Chemical PH: 7.0 to 8.0 Fructose : equal or more than 13 umol ACP : >= 200 umol Zinc : >= 2.4 umol

Routine analysis Motility Classify quality of motility, and report in percent; Progressive – forward movement > 32% Non-progressive – on the spot movement around in circles Non-motile – no movement Reference Value Motile > 40%

Routine analysis Normal Value .: 15 Million /mL(≥39million per total ejaculate)  Oligospermia, refers to semen with a low concentration of sperm and is a common finding in male infertility Azoospermia is the medical condition of a man not having any measurable level of sperm in his semen

Routine analysis Morphology Normal form >4%

variations Increased pH: infection Increased volume of semen: decreased sperm count Decreased volume of semen: infertility Increased turbidity: leukocytes (inflammatory process in some part of the reproductive tract)

variations Factors affecting motility: Complete liquefaction of the seminal fluid, temperature, Period of Abstinence, Manner of collection/preparation, Number of cells present, Type of movement of sperm cells

Motility defects connected with infertility: Aspermia: absence of semen Azoospermia: absence of sperm Oligospermia: low number of sperm Asthenozoospermia: poor sperm motility Teratozoospermia: sperm carry more morphological defects than usual