URINALYSIS AND BODY FLUIDS (SEMINAL FLUID) LECTURE

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URINALYSIS AND BODY FLUIDS (SEMINAL
FLUID)LECTURE

• Dr. Essam H. Jiffri

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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.

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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.

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

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Motility

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

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Motility

• - Approximately 25 high-power field should be
  examined.
• - A minimum motility of 50-60 percent with a
  quality of fair (2.0) is considered normal for
  specimens tested within the 3-hour time period.

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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.

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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.

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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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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.

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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.

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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.

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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.

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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.

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Normal values for Semen Analysis

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• Volume 2-5 ml
• Viscosity Pours in droplets
• pH 7.3-7.8
• Count 20-160 million/ml
• Motility gt 50-60 within 3 hours
• Quality gt 2.0 of fair
• Morphology lt 30 Abnormal forms
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