Semen Test: Introduction, Physical, chemical, microscopic examination,

Semen Test: Introduction, Physical, Chemical, Microscopic Examination, Normal Range of Sperm Count and Clinical Significance

Semen Test/ Analysis

Semen Test or Semen analysis or a sperm count test is an indicator that shows the health and viability of a man’s sperm. Semen is the fluid containing sperm and it is released during ejaculation. A semen test evaluates the number, shape, and movement/ motility of the sperm. Generally, two or three separate sperm analyses are recommended to get a good idea of sperm condition.

Semen Test Preparation

Collection of samples: Recommended following 3 days continence of after a period representing usual frequency or coitus.

Specimen collection in wide-mouth clean ( detergent free ) or another suitable container.

Do not collect directly into a condom since sperm may die by the cation of spermicidal power which is present in the condoms.

Specimens must be received as soon as possible and in no case after more than 2 hours.

Semen Sample Collection

It can be collected by following methods-

masturbation
sex with withdrawal before ejaculation
sex with a condom
ejaculation stimulated by electricity

Semen Test Parameters

Gross examination

Physical exam

Liquefication: complete in 30 minutes

pH normally, alkaline (7.0-7.7)

Viscosity can be assessed while pouring into another pot.

Volume: normally 1.5-5.0 ml.

Microscopic examination

Motility: a small drop of liquified semen is placed on a clean slide and coverslipped and motility is evaluated by counting 100 sperms including dead sperms after counting 100 note the motile only and given in %.

Total Sperm count = (N × 10×20× 1000)/4

Normal value: 30 million to 150 million per ml.

Morphology: Look at the sperms are they are in normal forms or in abnormal forms. In case of abnormal, the sperms look double-headed, swelling, or giant form.

Uses of semen Test

Test for male infertility
Test for vasectomy success

Semen Test Clinical Significance

Physical examination

Colour and appearance: Greyish-white, viscid, opaque (normal finding)

Clinical significance

Increased turbidity may associate with inflammatory processes in some parts of the reproductive tract.

Viscosity: The specimen of normal viscosity can be poured drop by drop.

Clinical significance

Increased viscosity is concerned with the poor invasion of the cervical mucus in post-coital studies. Absence of viscosity points to reduced cell content.

Volume: 2-5 ml (normal finding)

Clinical significance

A lesser amount may arouse suspicion of deficiency and premature weakening by vaginal acidity.

Liquefaction time: 20-30 minutes (normal finding)

Clinical significance

Failure to liquefy within 30 minutes may associate with infertility. The semen from males with bilateral congenital absence of the vas deferens and seminal vesicles fails to coagulate due to the absence of coagulation substrate.

Chemical examination

pH: 7.2-7.8 (normal finding)

Clinical significance

pH values less than 7.0 are frequently associated with semen consisting largely of prostate secretions due to congenital aplasia of the vasdeferens and seminal vesicles.

Fructose: 150-300 mg/dl (normal finding)

Clinical significance

Disorders of seminal vesicles may lead to a reduction in fructose concentration. There is an inverse relationship between fructose level and sperm count. High fructose values are associated with low sperm count.

Microscopic examinations

Sperm count: 30-150 millions/ml (normal value)

Clinical significance

The complete absence of spermatozoa is called azoospermia. A reduced number is termed oligozoospermia.

related clinical conditions:

mumps, orchitis, prostatitis, occlusion or absence of efferent ducts, hypopituitarism, hypogonadotropic hypogonadism. The sperm count may be low in estrogen secreting tumors and in hypo-and hyperthyroidism.

Motility after 2 hours, 3 hours, and 6 hours: 60-95% (normal finding)

Clinical significance

Motile forms decrease by about 5% per hour after the fourth hour following collection. Motility less than 60% may be associated with infertility.

Abnormal forms: 0-20%

Clinical significance

More than 20% of abnormal forms may be associated with infertility.

Following abnormalities in spermatozoa are observed.

Heads: too small, too large, double heads, pointed heads, ragged heads

Middle piece: absent, bifurcated, or swollen.

Tails: double, curved, rudimentary, or absent

pus cells: 1-2/ HPF (normal finding)

Clinical significance

Increased number of pus cells-Inflammation due to infection in some parts of the reproductive system. Infection of the seminal vesicle.

Epithelial cells: 1-2/HPF (normal finding)

Clinical significance

Increased number: not significant

Red blood cells: Absent (normal finding)

Clinical Significance

Tuberculosis of seminal vesicle, rupture of the blood vessel, infection of the prostate, vitamin C deficiency.

Trichomonas: Absent (normal finding)

Clinical significance

Trichomonas infection i.e. motile flagellate with pus cells

Keynotes on Semen Test/Analysis

Masturbation is considered the preferred way to get a clean sample.
Sperm count may affect by alcohol, caffeine, cimetidine, recreational drug use, tobacco, etc.
The normal appearance of semen should be whitish to gray and opalescent.
Abnormal semen tests may be due to infertility, hormonal imbalance, infection, disease, such as diabetes gene defects, exposure to radiation, etc.
Collection and examination time is also necessary for semen analysis. Semen should examine within 30 minutes.

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