FERTILITY & INFERTILITY
MALE RPRODUCTIVESYSTEM
TESTISHas oval shape with 4 x 3 x 2.5 cm dimensions, 12 gweight and 25 mL volumeExist out of body in scrotumHas two main functionsAs a cytogenic gland to produce spermatozoon orspermatozoidAs an endocrine gland to produce testosterone and otherhormonesIncludes about 250 testicular lobules, each of themhas two partsTubules including 1-4 seminiferous tubulsMatrix Tissue
Sertoli (Supporting) CellsProduction of anti-mullerian hormone(AMH)Production of androgen binding protein(ABP)Production of InhibinProduction of estradiolProduction of albumin and transferinNutritional supports
Leydig (Interstitial) CellsProduction of TestosteroneProduction of estradiol
Seminal VesiclesProvide Fluid and Nutrients For Sperm,ContainingFructoseProstaglandinsCoagulation factorsFlavins
Prostate GlandProvide Acidic Fluid ContainingCitric AcidZincAcid phosphataseSpermine
Bulbourethral (Cowper) GlandsAdd Alkaline Mucus ForNeutralizing acidity of prostatic fluidand vaginal secretionWetting and lubrication of urethrabefore ejaculation
SPERMOGRAM(SEMEN ANALYSIS)
SEMINAL COLLECTION &HANDELING2-5 Days After the Last Sexual ActivityIf necessary, repeat after 1 week and before 3 weeksFor postvasectomy semen analysis, specimens areroutinly tested at monthly intervals, beginning at 2months after vasectomy and continuing until twoconsecutive monthly specimens show no spermMasturbation Is Preferred Method For SemenCollectionContainer Should Be Clean & Wide MouthedTransport to Lab within 1 h & in Temperaturebetween 20 to 40 oCAnalyze within 1 h
MACROSCOPIC EXAMINATIONCoagulationLiquefactionColorAppearanceOdorViscositypHVolume
CoagulationCoagulation occurs shortly afterejaculationCoagulation is due to action of aclotting enzyme with prostatic origin,on a fibrinogen-like substance fromseminal vesicleIf Coagulation did not occur, it shouldbe reported
LiquefactionLiquefaction occurs within 30 min by actionof prostatic enzymes.If coagulation did not occur until 60 min, it isreported as abnormalAnalysis of the specimen cannot begin untilliquefaction has occurredIf after 2 h the specimen has not liquified,Amylase or chymotrypsin may be added toallow the rest of the analysis to be performedIf specimen delivered after 30 min, it is notpossible to evaluate properly coagulationand liquefaction
ColorNormal semen has a gray-white or lightyellow colorDeep yellow is associated with somedrugs or high concentration of flavinBrown or Red color may indicatepresense of blood
AppearanceNormal semen has translucent oropaque appearanceIncreased with turbidity indicatespresense of WBC
Viscosity is measuredby using a serologicalpipetteNormal semen isslightly viscous anddispenses drop by dropIncreased viscosity isdemonstrated byformation of a string offluid, longer than 2 cm,as the specimen isdispensed from apipetteViscosity
VolumeIs measured by using a serologicpipette or small graduated sylinderIs recorded in mililiters to one decimalplaceNormally is 2.0 to 5.0 mL1.5 – 4.0 mL from seminal vesicle0.2 – 1.0 mL from prostate0.2 mL sperm
MICROSCOPIC EXAMINATIONSperm ConcentrationTotal Sperm CountMotilityMorphologyCells
pHNormal semen pH is alkaline with arange of 7.2 – 8.0
TOTAL SPERM COUNTAzoospermiaOligospermiaPolyzoospermia
SPERM MOTILITYEvaluate MotilityWithin 1.0 h after specimen collectionAfter complete liquefactionOn a well-mixed specimenBy considering temperatureIn a fixed volume of specimenIn about 20 hpf fileds
SPERM MOTILITYProgressive MotilityNonprogressive MotilityNonmotile
SPERM MOTILITY
Sperm MorphologyDoubleTailDoubleHeadAmorphousFormConstrictedheadAcute TaperingFormSpermatid Pin Head Giant Head
Sperm in Semen Smear(Wright’s Stain)
SEMINAL CELLSSpermotocyteWhite CellRed CellEpithelial CellMicrorganism
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