THE ROLE OF MORPHOLOGY AND CONCENTRATION OF SEMINAL FLUID IN FERTILITY
TABLE OF CONTENTS
TITLE PAGE- – – – – – – – – i
CERTIFICATION – – – – – – – – ii
DEDICATION – – – – – – – – – iii
ACKNOWLEDGEMENT – – – – – – – vi
TABLE OF CONTENT- – – – – – – – v
CHAPTER ONE: INTRODUCTION
CHAPTER TWO: PHYSIOLOGY OF SEMEN
2.1 Physiology of Seminal Fluid – – – – – – 5
2.2 Health Implications of Seminal Fluid – – – – 9
2.3 Development of criteria for morphological normal
Spermatozoa- – – – – – – – 10
2.3.1 Early Approach- – – – – – – – 10
2.3.2 Modified Approach- – – – – – – 13
2.4 Principle of Sperm Morphology- – – – – 14
2.5 Epidemiology of decreasing normal sperm
morphology values- – – – – – – 16
2.6 The Role of Morphology and Concentration in fertility- – 18
2.6.1 The Role of Morphology in Fertility- – – – – 18
2.6.2 The Role of Concentration in Fertility- – – – 20
CHAPTER THREE: CLINICAL SIGNIFICANCE
3.1 Spermatozoa – – – – – – – – 22
3.2 Clinical Interpretation of Abnormal Viscosity of
Seminal Fluid- – – – – – – – 23
3.3. Significance of Semen Volume- – – – – 24
3.4 Sperm Concentration- – – – – – – 25
3.5 Sperm Morphology- – – – – – – 27
3.6 Tests for Semen Analysis- – – – – – 29
CHAPTER FOUR: SUMMARY AND CONCLUSION
4.1 Summary- – – – – – – – – 33
4.2 Conclusion- – – – – – – – – 33
References
CHAPTER ONE: INTRODUCTION
Semen, also known as seminal fluid, is an organic bodily fluid created to contain spermatozoa. It is secreted by the gonads (Sexual glands) and other sexual organs of male or hermaphroditic animals and can fertilize the female ovum. Semen is produced and originates from the seminal vesicle, which is located in the pelvis. The process that results in the discharge of semen from the urethral orifice is called ejaculation. In humans, seminal fluid which promote the survival of spermatozoa, and provide a medium through which they can move or “swim”. The fluid is designed to be discharged deep into the vagina, so the spermatozoa can pass into the uterus and form a zygote with an egg. Semen is also a form of genetic material. In animals semen has been collected for cryoconservation. Cryoconservation of animal genetic resources is a practice that calls for the collection of genetic material in efforts for conservation of a particular breed.
Male subfertility and infertility affect many couples during their reproductive age. The prevalence of these conditions has been increasing over the years (Skakkeback et al., 2016), representing a major burden for health care systems (Eshre et al., 2015). This has been related to intentional delayed child-bearing by couples, particularly in developed countries, as well as environmental and lifestyle factors (Lalinde-Acevedo et al., 2017). When a couple seeks medical counselling and assistance to achieve conception, workup of female factors usually comes first since it is commonly perceived that female factors are more significant in predicting the choice and success of associated reproductive technology (ART) (Agarwal et al., 2015).
Semen analysis is the key investigation of infertile men because it reflects the overall functionality of sperm production by the testes, the patency of the genital tract, as well as secretary activity of all accessory glands (Centola, 2014). This information contributes to the effective establishment of individual diagnosis (Jequier , 2004) and serves as the essential basic investigation of male factors in an infertile couple (Snow – Lisy and Sabanegh, 2013).
Standardization of semen analysis constitutes an important aspect of the investigation, not only to obtain valid and useful information but also to minimize intra and inter-laboratory variations. The World health Organization (WHO) defined reference values have been revised over the years, with the most recent and fifth update being issued in 2010 (WHO, 2010). The latest WHO recommendations are based on semen parameters from approximately 2000 fertile men, from eight countries and three continents, whose unprotected sexual intercourse (Cooper et al., 2010). This represents the first attempt to set reference values in an evidence-based approach. The inclusion of only semen analysis results from fertile patients in formulating the reference values is another pitfall. The WHO criteria should not be regarded as standard but rather a recommended reference for interpretation of human semen analysis results. It is likely that the reference values need to be revised regularly based on more recent data in addition to technical advances in semen analysis. Therefore, the reference limits for semen analysis should not be over-interpreted to distinguish fertile men from infertile men (Guzick et al, 2001). A specific diagnosis should be analysed within the context of a patient’s clinical history and physical examination.
Attempts have been made to improve “manual” semen assessment by laboratory technicians by incorporating more complex and innovative technological equipment and software to reduce individual subjectivity. However, despite all the advances, computer-associated sperm analysis (CASA) techniques are not widely used due to lack of accuracy and efficiency (Bjorndah et al., 2015). In this chapter, the conventional techniques used due to lack of accuracy and efficiency (Bjorndah et al., 2015). In this chapter, the conventional techniques used in routine semen analysis at Andrology laboratories, taking into account the reference values defined by WHO 5th edition criteria, are presented. Semen analysis adjunct tests, as well as the recent in LASA and its clinical role are also discussed.
