Semen analysis
description
Transcript of Semen analysis
![Page 1: Semen analysis](https://reader036.fdocuments.in/reader036/viewer/2022081417/5681657d550346895dd81215/html5/thumbnails/1.jpg)
![Page 2: Semen analysis](https://reader036.fdocuments.in/reader036/viewer/2022081417/5681657d550346895dd81215/html5/thumbnails/2.jpg)
Semen analysisWHO19806 ys5th edition: 2010Lower reference limits (5th
centiles and their 95% confidence intervals)
Pregnancy during 12mOther groupsNo guarantee
![Page 3: Semen analysis](https://reader036.fdocuments.in/reader036/viewer/2022081417/5681657d550346895dd81215/html5/thumbnails/3.jpg)
Motility4 A
3 B
2 C
1 D
![Page 4: Semen analysis](https://reader036.fdocuments.in/reader036/viewer/2022081417/5681657d550346895dd81215/html5/thumbnails/4.jpg)
A>25%A+B>50%
Systematic (manual method) :
Grade a → rapid progressive motility ( ≥25 µm/s at 37 0C ) Grade b → slow progressive motility ( 5-25µm/s at 37 0C) Grade c → non progressive motility (<5 µm/s ) Grade d → immotile
![Page 5: Semen analysis](https://reader036.fdocuments.in/reader036/viewer/2022081417/5681657d550346895dd81215/html5/thumbnails/5.jpg)
MotilityProgressive motility (PR)
Non-Progressive motility (NP)
Immotile (IM)
![Page 6: Semen analysis](https://reader036.fdocuments.in/reader036/viewer/2022081417/5681657d550346895dd81215/html5/thumbnails/6.jpg)
Sperm morphology classification systems
Normal reference range
1) Macleod >60%
2) WHO manual 2nd edition >50% 3) WHO manual 3rd edition >30% 4) ASCP (American society clinical pathology ) >80% 5) Strict (menkveld & kruger ) / WHO manual 4th edition >14%6) WHO 2010 >4%
![Page 7: Semen analysis](https://reader036.fdocuments.in/reader036/viewer/2022081417/5681657d550346895dd81215/html5/thumbnails/7.jpg)
Lower reference limits (5th centiles and their 95% confidence intervals) for semen
characteristics.
Lower reference limit Parameter1.5( 1.4–1.7) Semen volume )mL(
39( 33–46 )40 Total sperm number )106 per ej(15( 12–16 )20 Sperm concentration )106 per
mL(40( 38–42) Total motility )PR+NP, %(32( 31–34) Progressive motility )PR, %(
58( 55–63 )75 Vitality )live spermatozoa, %(4( 3.0–4.0 )14 Sperm morphology )normal
forms, %( ≥7.2 pH
![Page 8: Semen analysis](https://reader036.fdocuments.in/reader036/viewer/2022081417/5681657d550346895dd81215/html5/thumbnails/8.jpg)
DNA Damage/Fragmentation
may result from intra- or extra-testicular factors
can occur at any step of spermatogenesis
may result from aberrant chromatin packaging during spermiogenesis, defective apoptosis before ejaculation or excessive production of reactive oxygen species (ROS) in the ejaculate
![Page 9: Semen analysis](https://reader036.fdocuments.in/reader036/viewer/2022081417/5681657d550346895dd81215/html5/thumbnails/9.jpg)
Extra testicular factorsDrugs, Chemotherapy, RT
Cigarette smoking (accumulation of toxic agents including the products of cigarette smoke such as cadmium)
Genital tract inflammation,
![Page 10: Semen analysis](https://reader036.fdocuments.in/reader036/viewer/2022081417/5681657d550346895dd81215/html5/thumbnails/10.jpg)
VaricoceleTesticular hyperthermiaAndrogen deprivation at the
testicular level> 40yTesticular tumorsFebrile DisUTIHormonal factors, (FSH, T)
![Page 11: Semen analysis](https://reader036.fdocuments.in/reader036/viewer/2022081417/5681657d550346895dd81215/html5/thumbnails/11.jpg)
Environmental FactorsOccupational Exposure
(chemical, thermal)Cell phone Lap Top, Wi FiAgriculture, toxinsAir Pollution (traffic workers)HeatSmoking
![Page 12: Semen analysis](https://reader036.fdocuments.in/reader036/viewer/2022081417/5681657d550346895dd81215/html5/thumbnails/12.jpg)
IndicationsPredicting ART outcomeIdiopathic InfertilityMen older than 40yExposure to toxins and chemical
agentsHigh risk groups (Testicular
tumor, Varicocele, Smoking, alcohol or opium abuse, )
Abortion
![Page 13: Semen analysis](https://reader036.fdocuments.in/reader036/viewer/2022081417/5681657d550346895dd81215/html5/thumbnails/13.jpg)
Aniline blueToluidine blueSCSACommet assayCMA3Tunel
![Page 14: Semen analysis](https://reader036.fdocuments.in/reader036/viewer/2022081417/5681657d550346895dd81215/html5/thumbnails/14.jpg)
![Page 15: Semen analysis](https://reader036.fdocuments.in/reader036/viewer/2022081417/5681657d550346895dd81215/html5/thumbnails/15.jpg)
![Page 16: Semen analysis](https://reader036.fdocuments.in/reader036/viewer/2022081417/5681657d550346895dd81215/html5/thumbnails/16.jpg)
![Page 17: Semen analysis](https://reader036.fdocuments.in/reader036/viewer/2022081417/5681657d550346895dd81215/html5/thumbnails/17.jpg)
![Page 18: Semen analysis](https://reader036.fdocuments.in/reader036/viewer/2022081417/5681657d550346895dd81215/html5/thumbnails/18.jpg)
The effectiveness of IVF in unexplained infertility: a systematic Cochrane review
Zabeena Pandian1,3, Siladitya Bhattacharya1, Dimitrios Nikolaou1, Luke Vale2 and Allan Templeton1
1Department of Obstetrics & Gynaecology, Aberdeen Maternity Hospital and 2Health Services Research Unit, University of
Human Reproduction Vol.18, No.10 pp. 2001±2007, 2003
![Page 19: Semen analysis](https://reader036.fdocuments.in/reader036/viewer/2022081417/5681657d550346895dd81215/html5/thumbnails/19.jpg)
There was no signifcant difference in clinical pregnancy rates between IVF and expectant management.
There was no evidence of a difference in live birth rates between IVF and IUI either without (OR 1.96, 95% CI 0.88 to 4.36) or with (OR 1.15, 95% CI 0.55 to 2.42) ovarian stimulation.
Clinical pregnancy rates with IVF were signifcantly higher compared with GIFT (OR 2.14, 95% CI 1.08 to 4.22) as were the multiple pregnancy rates (OR 6.25, 95% CI 1.70 to 23.00).
![Page 20: Semen analysis](https://reader036.fdocuments.in/reader036/viewer/2022081417/5681657d550346895dd81215/html5/thumbnails/20.jpg)
CONCLUSIONS: The effectiveness of IVF in
unexplained infertility remains unproven.
Larger trials with adequate power are warranted.
![Page 21: Semen analysis](https://reader036.fdocuments.in/reader036/viewer/2022081417/5681657d550346895dd81215/html5/thumbnails/21.jpg)
Male infertility and environmental exposure to lead and cadmium
Susan Benoff, Asha Jacob, Ian R.Hurley
North Shore University Hospital. New York
Human Reproduction Update 2000. vol.6, No.2pp 107-121
![Page 22: Semen analysis](https://reader036.fdocuments.in/reader036/viewer/2022081417/5681657d550346895dd81215/html5/thumbnails/22.jpg)
Role of sperm chromatin abnormalities and DNA damage in male infertility
A.Agarwal1 and Tamer M.Said Center for Advanced Research in
Human Reproduction, Infertility, and Sexual Function, Glickman Urological Institute,
The Cleveland Clinic Foundation, Cleveland, Ohio, USA
Human Reproduction Update, Vol.9, No.4 pp. 331±345, 2003
![Page 23: Semen analysis](https://reader036.fdocuments.in/reader036/viewer/2022081417/5681657d550346895dd81215/html5/thumbnails/23.jpg)
Sperm DNA integrity is essential for the accurate transmission of genetic information.
Any form of sperm chromatin abnormalities or DNA damage may result in male infertility
in-vivo fecundity decreases progressively when >30% of the spermatozoa are identified as having DNA damage.
![Page 24: Semen analysis](https://reader036.fdocuments.in/reader036/viewer/2022081417/5681657d550346895dd81215/html5/thumbnails/24.jpg)
The clinical signifcance of this assessment lies in its association not only with natural conception rates, but also with assisted reproduction success rates.
Also, it has a serious impact on the offspring and is highly prognostic in the assessment of fertility in cancer patients.
![Page 25: Semen analysis](https://reader036.fdocuments.in/reader036/viewer/2022081417/5681657d550346895dd81215/html5/thumbnails/25.jpg)
Therefore, screening for sperm DNA damage may provide useful information in cases of male idiopathic infertility and in those men pursuing assisted reproduction. Treatment should include methods for prevention of sperm DNA damage.
![Page 26: Semen analysis](https://reader036.fdocuments.in/reader036/viewer/2022081417/5681657d550346895dd81215/html5/thumbnails/26.jpg)
![Page 27: Semen analysis](https://reader036.fdocuments.in/reader036/viewer/2022081417/5681657d550346895dd81215/html5/thumbnails/27.jpg)
![Page 28: Semen analysis](https://reader036.fdocuments.in/reader036/viewer/2022081417/5681657d550346895dd81215/html5/thumbnails/28.jpg)