FERTILITY & INFERTILITY

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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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