1 URINALYSIS AND BODY FLUIDS (SEMINAL FLUID) LECTURE Dr. Essam H. Jiffri

2 Seminal Fluid - Seminal fluid is the specimen that is most frequently received in clinical laboratories. - The two primary reasons for analysis are the evaluations of infertility cases and postvasectomy cases.

3 Seminal Fluid - Seminal fluid is composed of four fractions that are contributed individually by the bulbourethral and urethral glands, the testis and epididymis, the prostate, and the seminal vesicles.

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5 Seminal Fluid - Each fraction differs in its composition, and the mixing of all four fractions during ejaculation is necessary for the production of a normal semen specimen.

6 Seminal Fluid - Spermatozoa are produced in the testis and mature in the epididymis. - They account for only a small amount of the total semen volume, the majority of which is supplied by the seminal vesicles in the form of a viscous liquid that furnishes fructose and other nutrients to maintain the spermatozoa.

7 Seminal Fluid - The other significant contribution is made by the prostate and consists of a milky fluid that contains acid phosphatase and proteolytic enzymes that act on the fluid from the seminal vesicles, resulting in the coagulation and liquefaction of the semen. - Patients should receive detailed instructions concerning specimen collection.

8 Seminal Fluid - Specimens should be collected in sterile containers following a 3day period of sexual abstinence. - Plastic containers are not recommended, as decreased motility has been demonstrated in specimens remaining in plastic containers for over 50 minutes.

9 Seminal Fluid - The time of collection is essential for evaluation of semen liquefaction, and specimens awaiting motility analysis should be kept at 37 0 C.

10 Seminal Fluid -When evaluating semen specimens in cases of infertility, the following parameters are routinely measured; volume, viscosity, pH, sperm count, motility, and morphology.

11 Volume and Viscosity - Normal semen volume ranges between 2 and 5 ml and is measured by pouring the specimen into a graduated cylinder. - Viscosity can be determined as the specimen is being poured into the cylinder.

12 Volume and Viscosity - A specimen of normal viscosity will pour in droplets and will not appear clumped or stringy. - Ratings of 0 (watery) to 4 (gel-like) can be assigned to the viscosity report.

13 Volume and Viscosity - Always be sure that the specimen has completely liquefied prior to determining viscosity. - Increased viscosity or incomplete liquefaction will interfere with sperm motility.

14 Volume and Viscosity - Any abnormal appearance of the fluid such as the presence of blood, pigmentation, or increased turbidity that may be due to white blood cells should also be noted at this time. - The leukocyte esterase reagent strip test may be used to detect the presence of white blood cells.

15 pH - The pH of normal semen is slightly alkaline, with a range of 7.3 to 7.8, and can be measured using pH-testing paper. - An abnormally high ratio of prostatic fluid to seminal fluid will produce a more acidic pH.