Download Free Medical Semen Analysis PowerPoint Presentation

Semen Analysis PowerPoint Presentation

DOWNLOAD MEDICAL POWERPOINT PRESENTATION

About This Presentation

Description : This semen ppt presentation talk about abc of semen analysis

Tags : infertility,semen,pregnancy

Published on : Nov 08, 2021 | Views : 4638 | Downloads : 29

Shareable Url :

Embed Code :

Comment

Transcript

Slide 1-

SEMEN ANALYSIS Dr. Santanu Ghosh, MD (Psy), Ph.D (Psyc) Associate Professor, Psychiatry, Tripura Medical College, Agartala, Tripura
Slide 2-

5 Introduction 4 3 2 1 Indication of semen analysis Semen Collection Semen Analysis Computer assisted semen analysis Layout of Presentation
Slide 3-

Introduction A semen analysis measures the amount of semen a man produces and determines the number and quality of sperm in the semen sample. A semen analysis is usually on e of the first test done to exclude paternal cause of infertility A problem with the semen or sperm affects more than one- third of the couples who are unable to have children (infertile)
Slide 4-

ppt slide no 4 content not found
Slide 5-

The Ejaculate
Slide 6-

ppt slide no 6 content not found
Slide 7-

C B A Part of Investigation in Primary and secondary Infertility Test for vasectomy success (usually done 6 weeks after the vasectomy) Demand from court of law in legal disputes Indication of Semen Analysis Since semen samples may vary from day to day, 2 or 3 samples may be evaluated within a 3-6 month period for accurate testing
Slide 8-

Human sperm cell is about 70 µm long. The head size: 4-5µm Nucleus - contains the 23 chromosomes. Acrosome Mid-piece: 4-5µm The energy for motility is generated. Tail: 55µm Motility -Propagated along the tail.
Slide 9-

ppt slide no 9 content not found
Slide 10-

Standard guidelines for the collection of semen There should be 2 to 7 days of sexual abstinence before collection. Two separate samples at least 7 days apart should be analyzed. The duration of abstinence should be constant Masturbation in a clinical setting is the recommended procedure. Collection - Private room in the same centre where the semen will be analyzed. Pre warmed (21oC), sterile, non-toxic, wide-mouth container.
Slide 11-

PRECAUTIONS Pass urine. Wash hands with soap and dry. Glans and the penis should be cleaned with a wet paper towel (avoid soap). Lubricants should be avoided - interfere with motility. Collect the entire sample -70% of sperms is in the first part of the ejaculate. Other methods of collection Coitus interrupts Condom collection - Polyurethane - Latex
Slide 12-

Assistance - unable to achieve adequate erection and ejaculation. Phosphodiesterase type 5 inhibitors - 30 to 60 min before collection. Cavernosal and subcutaneous injections of prostaglandins Vacuum erection devices Vibratory stimulation - spinal cord injury. Rectal probe electro - stimulation induces ejaculation by stimulation of the efferent fibers of the hypo gastric plexus.
Slide 13-

LABELLING OF SAMPLE Patient name Age Clinic or Doctor name Laboratory analysis form: The period of abstinence (in days). Date &Time of collection. Mode of collection. Complete or incomplete. The time interval from collection to analysis.
Slide 14-

TIMING OF ANALYSIS Semen is placed in a 37° C gently shaking incubator for 30 minutes. The semen sample should be examined, Ideally within 30 mins Absolutely within 1 hour of collection. Motility decreases significantly after 2 hours
Slide 15-

ppt slide no 15 content not found
Slide 16-

ppt slide no 16 content not found
Slide 17-

Terminologies in SA (WHO) Leucospermia - Leucocyte present in semen, > 1 M/ml
Slide 18-

Normospermia Aspermia Hypospermia Hyperspermia Azoospermia Oligospermia Polyzoospermia Asthenozoospermia Teratozoospermia Leukospermia Hematospermia Necrozoospermia Normal semen volume No semen volume Semen volume < 1.5 ml Semen volume > 6.0 ml No spermatozoa in semen Sperm concentration <15 M/ml High sperm concentration, >200M/ml <40% grade (A&B) or < 32 PR% <4% spermatozoa - Leukocytes present in semen, >1M/ml Red blood cell present in semen “dead” sperm
Slide 19-

WET SMEAR PREPARATION Normally 10 ul semen to 190 ul water = 20x dilution. In cases of very low sperm count = 4x dilution In cases of azoospermia = no dilution Add 10 ul of mixture to the chamber Cover slip Wait 2-3 min to settle 20x magnification Sperm density = Sum of 5 squares x 106/ml
Slide 20-

The semen analysis characteristics can be classified into two groups. Macroscopic Microscopic
Slide 21-

Volume Normal: 1.5 ml per ejaculation Low volume (<1ml) reflect a problem Seminal vesicles and prostate, Retrograde ejaculation, Infection or lack of androgen. pH Normal: =/>7.2 (alkaline) Acidic pH (<7.0) in a low volume indicates Congenital bilateral absence of vas deferens (in which seminal vesicles are also poorly developed) Ejaculatory duct obstruction. Macroscopic Examination
Slide 22-

Macroscopic Examination…cont WHO criteria 2010 Description Whitish to grey opalescent Appearance Normal: Yellow (urine, jaundice) Pink/Reddish/Brown (RBCs) Liquefaction Normal: 15–30 minutes after collection >60 min Lack of prostatic protease, maybe sign of prostatic infection Viscosity Normal Smooth and watery Abnormal thick with long threads.
Slide 23-

Semen is ejaculated in liquid state. It gets coagulated due to enzyme PROTEIN KINASE from seminal vesicles. Absence of coagulation indicates CONGENITAL ABSENCE OF VAS DEFERENS,SEMINAL VESICLES OR OBSTRUCTION OF THE EJACULATORY DUCT LIQUEFACTION AT ROOM TEMPERATURE ,NORMAL SEMEN GETS LIQUEFIED WITHIN 30 MINUTES AFTER COLLECTION. Presence of MUCOUS STREAKS indicate incomplete liquefaction. Sometimes the sample may not liquefy. In this situation a treatment with PLASMIN 0.35 – 0.50 UNITS/ ML or CHYMOTRYPSIN 150 USP / ML may be needed to make the sample fit for analysis. Incomplete liquefaction is indicative of dysfunctional accessory reproductive organs like prostate which leads to decreased production of prostatic enzymes.
Slide 24-

FRUCTOLYSIS Fructose is main sugar present in seminal plasma & is imp. nutrient for the sperms. The quality of semen can be assessed by measuring the rate of utilization of fructose. FRUCTOLYTIC INDEX is the amount of fructose used or lactic acid formed by spermatozoa per hour at 37 deg. The semen sample should be well buffered otherwise the fructolysis will stop at certain stage & result will be erroneous. The normal fructose value is 13 mol or more per ejaculate. In case of azoospermia caused by congenital absence of vas deferens , low fructose level may indicate an assoc. dysgenesis of seminal vesicles. Fructose determination is also useful in rare cases of ejaculatory duct obstruction. There is positive correlation between rate of anaerobic fructolysis & deg. of motility.
Slide 25-

MICROSCOPIC ASSESSMENT OF SEMEN Sperm agglutination Count and concentration Motility Morphology Viability Non sperm cells
Slide 26-

SPERM AGGLUTINATION Wet smear Sperm form clumps within semen Sperm-to-non sperm elements (nonspecific agglutination)- accessory gland infection. Sperm-to-sperm agglutination (site-specific agglutination) – anti sperm antibodies. When agglutination is observed - semen cultures and antibody assessment.
Slide 27-

COUNT AND CONCENTRATION. Sperm concentration (number of sperm per milliliter) Sperm count (number of sperm per ejaculate) Azoospermia (absence of sperm) Abnormal spermatogenesis, ejaculatory dysfunction, or obstruction. Oligospermia (abnormally lower sperm concentration) Polyzoospermia (abnormally elevated sperm concentration) - rare. May be caused by a long period of abstinence - associated with sperm of poor quality.
Slide 28-

MOTILITY Most important predictor of the functional aspect of spermatozoa. Sperm motility is a reflection of the normal development of the axoneme. Sperm motility is a reflection of the normal maturation within the epididymis. The sperm motility is graded according to the WHO as follows: A—Rapid forward progress motility; B—Slow or sluggish progressive motility; C—Non progressive motility; D—Immotility. The cutoff value for normal 32% grade A motility 40% grade A+B
Slide 29-

Limitation of sperm motility assessment The method most commonly employed is the simple estimation of the motility of sperm on several fields. Assessment of this parameter is subjective - potential for technical mistakes. In-vitro motility of sperm may not reflect the true motility within the female reproductive tract.
Slide 30-

Causes of asthenospermia Inherent defects of sperm, Artifactual - Spermicides, Lubricants, Or Rubber Condoms. Prolonged Abstinence Periods, Genital Tract Infection, Varicocele. ASA - peculiar shaking pattern – preventing penetration through cervical mucus. > 10% to 15% of clumping of spermatozoa is indicative of antisperm antibodies
Slide 31-

HABITUAL FACTORS AFFECTING SPERM DENSITY / MOTILITY High intake of soya – decrease sperm density. High consumption of tobacco – decrease sperm density / motility. Consumption of cocaine / Marijuana – decrease sperm motility. Vaginal lubricants – decrease sperm motility. Alcoholism – affects all semen parameters.
Slide 32-

Viability When the motility is reported as less than 5% to 10% To differentiate immotile from dead sperm Staining method (commonly used) Hypo-osmotic swelling test (HOST) (alternative) Staining method (commonly used) Eosin Y followed by counter staining with Nigrosin. Principle is that viable sperm have intact cell membranes. Do not take up the dye and will remain unstained.
Slide 33-

Hypo-osmotic swelling test (HOST) (alternative) Exposure of the sperm to hypo osmotic fluid. Principle is that viable sperm have intact cell membranes. Cause swelling of the cytoplasmic space and curling of the sperm tail. Nonviable sperm - will not exhibit this effect. Reproducible and relatively inexpensive test Helps in selection of viable sperm - IVF or ICSI.
Slide 34-

NON SPERM CELLS Leukocytes: normally (1-4/HPF) Leukocytospermia as levels above 1 × 106 WBC/mL - infection Epithelial cells: normally (1-2/HPF) Spermatocytes: (Immature germ cells) 1-2/HPF Erythrocytes: (1-2/HPF). Increased number may indicate a reproductive tract infection or damage to a small capillary during sample production. Bacteria and protozoan such as Trichomonas vaginalis are uncommon in human semen but their presence is indicative of possible male reproductive tract infection
Slide 35-

COMPUTER ASSISTED SEMEN ANALYSIS (CASA)
Slide 36-

Advantages: High precision Quantitative assessment of sperm kinetics. Disadvantages: Expensive equipment and still requires the subjective participation of a technician. Hence not used for routine semen analysis Commonly done in high volume andrology labs. Emerging use of ICSI - diminished the role of motility assessment in sperm selection. Computer-assisted sperm analysis (CASA) It is a semiautomated technique that provides data on Sperm density, Motility (straight line and curvilinear velocity, linearity, average path velocity, amplitude of lateral head displacement, flagellar beat frequency, and hyper activation)
Slide 37-

ISAS (Integrated Semen Analysis System) SCA (Sperm Class Analyzer) IVOS (Integrated Visual Optical System ) SQA-V (Sperm Quality Analyzer)
Slide 38-

ISAS (Integrated Semen Analysis System) ISAS is a CASA system based on image analysis. ISAS analyzes motility and concentration in more than 17 sperm parameters ISAS also do DNA fragmentation analysis
Slide 39-

SCA (Sperm Class Analyzer) SCA provides fast, accurate and repeatable results. SCA Motility & Concentration SCA DNA Fragmentation Morphology SCA Vitality
Slide 40-

IVOS (Integrated Visual Optical System ) The IVOS is unique in that it is the only CASA system that integrates the optical system within the unit, so that an external microscope is not needed. Able to analyze sperm of multiple species (rat) (Research institutes, IVF clinics, pharmaceutical companies, reproductive toxicology labs, veterinary and animal breeding centres) A single field - analyzed in just 0.5 second.
Slide 41-

SQA-V (Sperm Quality Analyzer) Fully automated SQA-V semen analysis eliminates inter-operator variation. Electro-optics, computer algorithms and video microscopy Provide a precise and accurate - 75 second The SQA-V ( 16 clinical parameters )
Slide 42-

Limitation of semen analysis Clinical research has shown, Normal semen analysis may not reflect the true fertility status of an individual. Men with poor sperm parameters can cause spontaneous pregnancies. Men with good sperm parameters are still subfertile Only 50% of subfertile men have recognizable causes detectable by semen analysis. Semen analysis is only a surrogate test to measure the man’s fertility potential.
Slide 43-

SPERM FUNCTION ASSESSMENT Sperm- mucus interaction assay Acrosome reaction testing Sperm penetration assay
Slide 44-

SPERM-MUCUS INTERACTION/POSTCOITAL TEST Assess cervical environment as a cause of infertility. Cervical mucus - heterogenous fluid - cyclical changes in consistency Postcoital test (PCT) Conducted when the cervical mucus is thin and clear just before ovulation. Examined 2 to 8 hours after normal intercourse. Progressively motile sperm > 10 to 20 per HPF is designated as normal. Abnormal test - advised to proceed with IUI. Inappropriate timing testing / intercourse, Anatomic abnormalities, Semen or cervical mucus antisperm antibodies, Abnormal sperm.
Slide 45-

ACROSOME REACTION The Acrosome is a membrane-bound organelle covers the anterior 2/3 of the sperm head. Acrosome reaction is an important prerequisite for successful fertilization. ZP3 Involves fusion of acrosomal membrane and plasma membrane. Acrosin and Hyaluronidase – required to digest the oocyte cumulus cells and ZP Acrosome reaction testing - not widely practiced in laboratories - research interest. Profound abnormalities of head morphology Unexplained infertility
Slide 46-

SPERM PENETRATION ASSAYS The sperm penetration assay (SPA) or the hamster egg penetration assay (HEPT) It address the functional ability. Unexplained infertility / IVF failure Principle - a normal spermatozoa can bind and penetrate the oocyte membrane. Incubating zona-free hamster oocytes in sperm droplets for 1 to 2 hours. The oocytes are examined microscopically for sperm penetration. Penetrations are indicated by swollen sperm heads within the oocyte cytoplasm. Normally, 10% to 30% of ova are penetrated (WHO, 1999). Oligozoospermic and severely teratospermic men – negative testing Sperm capacitation index (SCI) is a variant of the SPA test, assessing the mean number of penetrations per ovum. ICSI has been recommended - SCI less than 5 instead of standard IVF procedures.
Slide 47-

ADVANCED SPERM TESTING Antisperm antibody testing Electron microscopy Sperm DNA damage assay
Slide 48-

Antisperm Antibody Testing AB Against sperm IgG, IgA Sperm agglutinating, Sperm immobilizing, Spermotoxic. Normally the tight Sertoli-cell junctions provide the testis with a barrier that prevents the immune system from coming in contact with the post-meiotic germ cells. This unique barrier can be violated, Testicular torsion, Vasectomy, Testicular trauma, testicular surgeries
Slide 49-

Sperm agglutinating AB: Agglutination of spermatozoa, which reduces the availability of motile spermatozoa penetrating the cervical mucus. Sperm immobilizing AB: Induce loss in motility of the sperm - Characteristic “shaking” pattern in motility on postcoital test. Spermotoxic AB: Complement-dependent loss in viability of spermatozoa.
Slide 50-

Testing of ASA Direct ASA test detects sperm-bound immunoglobulins. (preferred) Indirect testing detects the biologic activity of circulating ASA. Sperm MAR(mixed antiglobulin reaction ) are recommended screening tests that are economical and readily available. Immunobead Test (IBT), which measures IgG, IgA, and IgM, may be additionally recommended when the previous tests gives a positive result. Acceptable normal values by WHO (1992) standards Less than 10% (IgG MAR) Less than 20% (IBT). Less than 50% WHO 2010
Slide 51-

Clinical implications of ASA on male infertility. 10% of sub fertile men. 2% of fertile men. ASA are present in 34% to 74% of vasectomized men. Persist in 38% to 60% after vasectomy reversal. Does not affect the decision to do a vasectomy reversal. Routine testing is not recommended (IVF versus ICSI) in immunologic infertility Inability for ZP binding, ICSI is the procedure of choice.
Slide 52-

ELECTRON MICROSCOPY A viable sperm still can be defective. Ultra structural details of the sperm can only be seen under the electron microscope (EM). Candidates: Low sperm motility (<5% to 10%) with high viability & density. Findings, Less intact acrosome membrane, More droplets attached to the acrosome membrane. Mitochondrial & Micro tubular defects- not visible under the usual Papanicolaou smear can be detected. Selection of sperm for ICSI
Slide 53-

SPERM DNA DAMAGE DNA fragmentation was initially described in 1993 Chromatin -Tightly packed. Disulfide cross linkages between protamines. DNA damage is multifactorial. Protamine deficiency. Mutations - affect DNA packaging or compaction during spermiogenesis. Tobacco use, chemotherapy, testicular carcinoma, and other systemic cancers. DNA damage is correlated positively with poor semen parameters. Selection of sperm for ICSI
Slide 54-

Do you have any questions?
Slide 55-

Text Text Text Text
Slide 56-

2 1 3 4 2. Example Text 3. Example Text 4. Example Text Click to add your text. Click to add your text. Click to add your text. Your Title Text Here – Stairs
Slide 57-

PRE – EJACULATORY FRACTION 1. Example Text 2. Example Text 3. Example Text 4. Example Text The Ejaculate Normal semen is an admixture of spermatozoa suspended in secretions (SEMINAL PLASMA ) from the glandular tissue of the male genital system. The ejaculate can be divided into four fractions: 1) PRE – EJACULATORY FRACTION : It is clear secretion of COWPER’S or LITTER’S GLANDS & contains proteins with moderately viscous consistency, which may possibly serve to neutralize residues of urine . 2)PRELIMNARY FRACTION : This originates from the prostrate gland. It gives SEMEN it’s characteristic ODOUR. It contain enzymes which liquefies the spermatozoa coagulum. 3)MAIN FRACTION : It originates from the SEMINAL VESICLES, TESTES, EPIDIDYMIS & partially from the prostate gland. The preliminary fraction & the main fraction contain majority of spermatozoa. 4)TERMINAL FRACTION : Is formed by secretions of seminal vesicles & is entirely gelatinous in consistency ,with large no. of immotile spermatozoa.
Slide 58-

Your Title Text Here – Steps Example Text. Click to add your text. Example Text. Click to add your text. Example Text. Click to add your text. Example Text. Click to add your text. Lorem Ipsum is simply dummy text of the printing and typesetting industry.
Slide 59-

Your Title Text Here – Lists
Slide 60-

Example Text Example Text Example Text Example Text Example Text Example Text Example Text Example Text Example Text Your Title Text Here – Timeline 2011 2012 2013 2014 2015 2016 2017 2018
Slide 61-

Your Title Text Here
Slide 62-

Your Title Text Here
Slide 63-

Example Text. Click to add your text. Example Text. Click to add your text. Your Title Text Here Example Text. Click to add your text. Example Text. Click to add your text.
Slide 64-

Your Title Text Here
Slide 65-

ppt slide no 65 content not found
Slide 66-

ppt slide no 66 content not found
Slide 67-

Example Text Example Text Example Text Example Text
Slide 68-

ppt slide no 68 content not found
Slide 69-

ppt slide no 69 content not found
Slide 70-

Lorem is simp dummy text of then and scrambled it to make a type specimen book. Example Text Example Text Piece 03 Example Text Piece 02 Example Text Piece 01 Example Text Piece 04 Example Text Piece 05
Slide 71-

YOUR TEXT HERE
Slide 72-

ppt slide no 72 content not found
Slide 73-

ppt slide no 73 content not found
Slide 74-

ppt slide no 74 content not found
Slide 75-

YOUR TEXT HERE YOUR TEXT HERE YOUR TEXT HERE Text Text Text Text Text Text
Slide 76-

ppt slide no 76 content not found
Slide 77-

Text Text Text YOUR TEXT HERE Text Text
Slide 78-

ppt slide no 78 content not found
Slide 79-

ppt slide no 79 content not found
Slide 80-

ppt slide no 80 content not found
Slide 81-

ppt slide no 81 content not found
Slide 82-

ppt slide no 82 content not found
Slide 83-

Text Text Text Text Text 1 2 3 4 5 Text Text Text Text Text Text Text
Slide 84-

Print master Lorem Ipsum is simply dummy text of the printing and typesetting industry. Lorem Ipsum has been the industry's standard dummy text ever since the 1500s, when an unknown printer took a galley of type and scrambled it to make a type specimen book. It has survived not only five centuries, but also the leap into electronic typesetting, remaining essentially unchanged. It was popularised in the 1960s with the release of Letraset sheets containing Lorem Ipsum passages, and more recently with desktop publishing software like Aldus PageMaker including versions of Lorem Ipsum.