What Are the Different Methods of Collecting Semen?

Semen routine is short for routine semen examination; it is one of the simple and popular laboratory examination methods in urology, andrology, and reproductive medicine. It is also one of the important parameters often used in gynecology.

Routine semen examination

Introduction to routine semen examination

Semen is composed of sperm and seminal plasma, of which 10% is sperm, and the rest is seminal plasma. In addition to water, fructose, protein and fat, it also contains a variety of enzymes and inorganic salts. Semen contains zinc.

Sperm semen is produced by the testes. Seminal plasma is produced by the prostate, seminal vesicle glands, and urethral glands. The seminal plasma contains fructose and protein, which are the nutrients of sperm. In addition, seminal plasma also contains prostaglandins and some enzymes. Normal semen is milky white, pale yellow, or colorless, and the number of sperm in a semen is generally 60 million to 200 million. Motile sperm account for more than 60% of the total. Malformed sperm should be less than 10% of the total. Sperm motility lasts 3-4 hours at room temperature.

The semen is alkaline and the inside of the female genitals is acidic. Therefore, semen is neutralized when it enters the woman.

The fifth edition of the "Human Semen Laboratory Test Manual" "normal semen standards" issued by the WHO in 2010 is shown in Table 1-1 below:

Table 1-1 Normal semen standards

	result	Normal reference value		result	Normal reference value
Exterior		Normal: Uniform milky white, semi-fluid	Sperm count		Not less than 39 million per ejaculation
Semen volume		1.5ml or more	Sperm viability		58% or more
pH value		7.2 or more	Sperm motility		40% or more (a + b + c) Or above 32% (a + b)
Liquefaction time		Within 60 minutes at room temperature, generally no more than 15 minutes	Normal form		4% or more
Sperm density		Above 15 million / ml	leukocyte		Less than 1 × 10 / ml

The fertility of a normal male ejaculation volume is 2-6 ml, with an average of 3.5 ml. The amount of ejaculation is negatively correlated with the frequency of ejaculation. If the amount of ejaculation is still less than 2 ml after 5-7 days of abstinence, the semen is considered to be reduced; if it is not ejaculated, it is called aspermia. Seminal plasma is a medium for sperm motility, and can neutralize acidic secretions of the vagina, so as not to affect sperm motility. Reduced semen volume (insufficient seminal plasma) is not conducive to sperm entering the uterus and fallopian tubes through the vagina, affecting fertilization. If the amount of ejaculation exceeds 8 ml, the sperm is diluted, which is not conducive to fertility. This can be caused by the excessive secretion of gonadotropin in the anterior pituitary gland and the increase in androgen levels can also be seen in people who have been abstinent for too long.

Semen contains a kind of antibacterial substance comparable to penicillin --- cytoplasmin of semen. Experts point out that semen cytosin is a protein with a unique function. Once the substance enters the inside of the cell, it can prevent the synthesis of RNA and thus kill bacteria. Observed from laboratory culture, semen cytosin can kill a variety of pathogenic bacteria such as staphylococcus and streptococcus.

Semen routine inspection requirements

If semen is taken for examination, it is best not to perform ejaculation within 5 days before the examination. Generally, semen can be collected by masturbation or by special condoms during sexual intercourse. After the semen is collected, it should be stored in a dry, clean bottle and sent immediately for inspection.

Semen is a type of body fluid. Therefore, many sexually transmitted diseases can be transmitted to each other through semen. The semen of AIDS patients contains the AIDS virus, so they can be transmitted to each other through sexual intercourse. Anal sex is a dangerous sex because the tissues near the anus are more vulnerable. If there is a wound rupture, the semen with HIV can be transmitted through the wound to the anal sex. This is why gay men are more likely to get AIDS. As long as there is fluid communication, heterosexual sex can also transmit sexually transmitted diseases.

"The amount of semen that a male can discharge throughout his life is about four buckets (about 80 liters). When he uses up the last drop of semen, a bead with the word" End "written on it will emerge. - a joke

In order to identify male fertility, doctors often ask the man to have a semen test. The normal semen color is gray or milky. If the abstinence time is long, it can be pale yellow, if bright red. Dark red, it indicates that the patient has inflammation or reproductive tract damage. The amount of ejaculation each time is 2 ~ 6 ml, which is often affected by the number and frequency of ejaculation. Fresh semen is thick and jelly-like. It should be liquefied into a thin liquid within 1 hour. Use a small glass rod to insert it into the semen and lift it. The length of the semen filaments generally does not exceed 2 cm, otherwise it is considered abnormal. The semen was weakly alkaline with a pH of 7.2 to 7.8. Normal sperm count should exceed 20 million / ml. Active semen> = 50% within 1 hour after ejaculation. The World Health Organization recommends that sperm motility be divided into four levels: level 0: inactive; level 1: sperm sway in place; level 2: moderate forward motion; level 3: active forward motion, fast linear motion. The normal sperm motility is grade 2 ~ 3 sperm> = 40% ~ 50%. Sperm shape: abnormal sperm is less than 50%. The analysis of male fertility can not be concluded only from an index of semen. Comprehensive analysis of the sperm quantity vitality activity rate liquefaction time abnormality rate and other aspects should be performed. Sexual life must be stopped within 5 to 7 days before semen collection, and there must be no masturbation, dream relics, etc. It is also necessary to quit smoking and alcohol, and avoid taking drugs that have an effect on spermatogenesis.

It is better to take semen in the morning. Wash your hands and genitals, especially the glans, with warm water before collecting sperm. Can use masturbation or electric massage ejaculation to cause ejaculation. The discharge of semen has a certain order. The first part comes from the prostate, epididymis and ampulla, with a large number of sperm, and the last part comes from the seminal vesicle. Therefore, the entire semen should be collected, not to miss any part, especially the first part. Because the first part of semen is easily lost, semen cannot be collected by external ejaculation. The container holding the semen should be clean, sterile, and dry. The temperature of the container before the sperm should be the same as the room temperature; the bottle should not be too large, but the mouth of the bottle should not be too small to prevent the semen from being ejected out of the bottle; it should also be labeled. Record the name and retrieval time. In cold weather, semen specimens should be kept warm, placed in a lingerie bag, not tilted or inverted, and delivered to the laboratory within 1 hour if possible.

Abnormal factors of routine semen examination

1.Computer radiation

Many young people lack sleep, and the endocrine disorders they cause not only cause a variety of diseases, but also affect sperm motility, making it difficult for women to conceive. If it is soaked online all the time, long-term computer radiation will cause great damage to the testes, and the decline of spermatogenesis is inevitable.

Disease

Of young people are open-minded but do not know how to protect themselves. If the infection is not actively treated, it can lead to epididymitis and orchitis. The former is to block the vas deferens, and the latter is to make the spermatogenic function worse.

Boys in puberty should be careful of mumps. Although mumps is a self-healing disease, if you don't take a good rest, take medicine, and stay up late as before, which will lead to a decline in resistance, it may cause testicular atrophy, spermatogenesis, or even azoospermia.

Varicocele and testicular hydrocele can damage the testes and cause spermatogenic disorders. Moreover, the older you are, the more severe the damage to your sperm.

3.High temperature

Sperm are extremely sensitive to temperature problems. In general, testicular temperature is 1-2 degrees Celsius lower than body temperature, which is most conducive to sperm production. However, many men like to soak in the hot springs, while others consider wearing tight pants as a fashion, which will cause the temperature of the testicles to rise above 37 ° C, thereby inhibiting sperm production. The same is true for riding a motorcycle and driving a long-distance bus. High seat cushion temperature affects testicular spermatogenesis, and prolonged compression of the perineum can cause prostatitis.

4.Fried food

Many people know that "gluttony" can affect health, but they may not know that infertility may also be "eaten". One of the hidden dangers is barbecue and fried foods. For example, there is a substance called propionamide in fried foods. Excessive intake can cause cancer and kill sperm. French fries, biscuits, and other foods contain trans fatty acids, which can inhibit androgen secretion, so men who love snacks have reduced sexual function, and sperm count will also decrease.

5.Some traditional Chinese medicine

Eating cottonseed can prevent pregnancy, the reason is that cottonseed has a spermicidal effect. But for young couples without children, this contraceptive method is likely to go too far and cause infertility. Snake bed has aphrodisiac effects, many men use it to enhance sexual function. But it also reduces sperm motility. Men still need to take less of these drugs. Sophora flavescens also has a spermicidal effect. It is recommended to drink herbal tea to pay attention to whether it contains such drugs.

Semen routine inspection

1. The amount of semen is normal. The amount of ejaculation per person is about 2-6 ml, 1-2 ml is a suspected abnormality, and less than 1 ml or more than 7 ml are considered abnormal. The measurement of semen volume is related to the abstinence time before the specimen is taken. The abstinence time is long and the semen volume is relatively large. Generally, it is advisable to abstain for 3-7 days.

In pathological conditions, when the amount of ejaculation is more than 7ml, not only the sperm density is reduced, but also the ejaculation is easy to flow out of the vagina, so that the total number of sperm is reduced. It is common in seminal vesicle inflammation; less. At this time, the contact area between semen and the female reproductive tract is small, or infertility is caused by the stickiness that prevents sperm from entering the woman's cervix. It is common in severe paragonaditis, low testosterone levels, blocked ejaculation ducts, and retrograde ejaculation.

2. Sperm density is generally expressed as the number of spermatozoa per milliliter of semen. The sperm density of normal people is between 20 million and 1.5 million / ml, which varies greatly from individual to individual. Less than 20 million / ml is oligozoospermia, which is seen in various reasons such as spermatogenic dysfunction, which may result in poor fertility or infertility due to reduced chance of sperm entering the uterine cavity and fallopian tubes; greater than 2.5 100 million / ml is polyspermia, sperm motility is affected; if sperm are not found in semen after multiple inspections or centrifugation, it is azoospermia. All three are infertility factors. It should be noted that some people have less than 20 million / ml, and because of their strong sperm motility, low deformity rate can also be raised. If the total number of spermatozoa is less than 20 million per milliliter, it is basically impossible to conceive naturally.

3. After the normal semen is liquefied, it becomes gelatinous under the action of seminal vesicle coagulase, and becomes less viscous liquid after 5-30 minutes. If it does not liquefy for more than half an hour, the semen does not liquefy, and sperm cannot move freely, which leads to male infertility. In addition, contact the glass rod with the liquefied semen, observe the consistency, and gently lift it to form semen filaments, whose length is less than 2 cm under normal conditions.

4. Normal malformation rate The head of the sperm is flat ellipse and the tail is curved, similar to the tadpole; however, some of the heads are pointed, big, double-headed, and the body tail is short, bifurcated, and double-tailed. If more than 30% of these malformed sperm are called malformed spermatozoa, they can cause infertility.

5, how to check the abnormal sperm of men? The color of normal semen is grayish white or pale yellow. If there is blood in the semen and it turns red or pink, it is bloody semen. A large number of red blood cells can be seen under the microscope. It is common in inflammation of the paragonads and posterior urethra and occasionally in tuberculosis or tumors. If the semen contains yellow secretions, then For purulent semen, a large number of pus bulbs can be seen under the microscope, suggesting inflammation in the genital tract or parathyroid glands.

6. The pH of normal people's semen is between 7: 2-7: 8, too acid or alkali is not conducive to sperm activity and metabolism. Less than 7: 2 is seen in blocked ejaculation ducts or contaminated with urine; more than 7: 8 is seen in seminal vesicle inflammation or old specimens.

7. Inflammatory cells: Leukocytes in normal semen should be less than a "+" sign. Leukocytosis indicates infection in the genital tract or paragonads.

8. Survival rate is usually within one hour after ejaculation. Motile sperm should be no less than 70% (generally 60-80%). If less than 60%, it is weak spermatozoa; if all sperm in the semen are Dead is spermatozoa.

9, motility sperm motility is generally divided into four levels. Level 0 refers to inactive sperm; level 1 refers to sperm that is moving in place; level 2 refers to a sperm that swims slowly forward; level 3 refers to a sperm that swims straight ahead; level 4 refers to a fast straight forward movement sperm. Generally, it is possible to fertilize the eggs with sperm of level 3 or higher. Generally, grade 3 + grade 4 (some marked as grade a + grade b) sperm 50%. Common causes of decreased sperm motility and survival include paragonadal inflammation, varicocele, ciliary immobility syndrome caused by chronic respiratory infections, the presence of antisperm antibodies in the semen, or improperly stored specimens.

Semen routine examination classification

Routine examination of semen

(1) Sperm volume: 2 to 5 ml of spermatozoa in normal people.

(2) Color and transparency: Normally the semen just ejected is milky white or off-white, and it is translucent milky white after liquefaction. Those who haven't spermatozoon for a long time can be light yellow. Bright red or dark red blood sperm is seen in reproductive system inflammation, tuberculosis, and tumors, and yellow pus-like semen is seen in seminal vesiculitis or prostatitis.

(3) Viscosity and liquefaction: Normally fresh semen is viscous jelly a few seconds after it is discharged, and begins to liquefy after 30 minutes under the action of plasmin in the semen. If the consistency is reduced like rice soup, it may be that the sperm count is reduced, which is seen in inflammation of the reproductive system, and semen does not coagulate, which is seen in the seminal vesicle obstruction or damage; if the semen does not liquefy after 1 hour, it may be caused by inflammation that destroys fibrinolytic enzymes, such as the prostate Inflammation and sperm liquefaction can inhibit sperm motility and affect pregnancy.

(4) pH: pH value. Normal semen is weakly alkaline pH 7.2 to 8.0, which is good for neutralizing acidic vaginal secretions. PH values less than 7 or greater than 8 can affect sperm activity and metabolism, which is not conducive to conception.

Routine semen examination microscopy

(1) Sperm survival rate: 30-60 minutes after ejaculation, the normal sperm survival rate should be 80% to 90%. Decreased sperm survival rate is an important cause of infertility.

(2) Sperm motility: refers to the state of sperm motility and also refers to the quality of motile sperm. The World Health Organization (WHO) recommends that the sperm motility be divided into 4 levels: sperm motility is good, movement is fast, lively and powerful, and straight line movement; sperm motility is good, movement speed is acceptable, swimming direction is indefinite, straight line Or non-linear movement with convolution; sperm movement is poor, slow movement, spinning or shaking in place, poor ability to move forward; dead sperm, sperm completely inactive. Normal sperm motility should be above grade . If> 40% of sperm motility is poor (, ), it is often an important cause of male infertility. Sperm motility is low, mainly seen in varicocele, non-specific infection of the urogenital system, caused by the application of certain drugs such as antimalarials, androgens.

(3) Sperm count: normal people have a sperm count of 0.6 × 1012 to 1.5 × 0.012 / L, which is equivalent to a total of 400 × 106 to 600 × 106. When the sperm count is less than 20 × 106 / ml or the total number of spermatozoa is less than 100 × 106, the number of spermatozoa is reduced, which leads to infertility due to exceeding the fertility threshold. No sperm was found to be azoospermia after direct smear or centrifugal sedimentation. It is found in congenital testicular hypoplasia, deformity or acquired testicular damage and atrophy (such as endocrine diseases such as testicular tuberculosis, inflammation, gonorrhea, pituitary or adrenal dysfunction), obstruction of the vas deferens or congenital defects of the vas deferens and seminal vesicles. An important cause of azoospermia or azoospermia is also an important cause of infertility. Checking for the presence of sperm is also an observation of the effect of vasectomy. After six weeks of ligation, the sperm were continuously checked, indicating that the operation was successful. If the sperm were still in the semen after two months of ligation, the operation was unsuccessful.

(4) Sperm morphology: In normal semen, abnormal morphological sperm should be less than 10% to 15%. If the number of abnormal morphological sperm in the semen is greater than 20%, it will cause infertility, which may be due to varicocele and toxic blood. Metabolites, lead contamination, etc. or abnormal sperm morphology caused by application of large doses of radiation and use of cytotoxic drugs. If> 1% of pathological immature cells are found in the semen, including spermatogonia, spermatocytes, and underdeveloped spermatids, it is suggested that the seminiferous tubules of the testis are affected or damaged by drugs or other factors. If sperm agglutination is> 10%, it may indicate reproductive tract infection or abnormal immune function.

Semen less than 1.5ml; not liquefied or incompletely liquefied 30 minutes after ex vivo; less than 40% of motile sperm; or poor sperm motility; sperm count below 0.6 million / ml; normal sperm count less than 80 % Of them may cause infertility. Less semen volume is more common in seminal vesicles and prostate diseases; azoospermia or too little sperm are more common in tuberculosis and non-specific inflammation of the reproductive system, such as mumps with orchitis and testicular dysplasia; a large number of white blood cells in semen are common in seminal vesicles and prostatitis Or tuberculosis; a large number of red blood cells in semen are common in seminal vesicle tuberculosis and prostate cancer.

Conditions for routine semen examination

Subjects, after undergoing a period of regular detoxification, have intercourse for 5-7 days (the interval between the last detox and the time of specimen collection must be at least 100 hours); ^[1] Prepare a clean and dry container with a large mouth and a lid for masturbation The semen was obtained by injection into the container at one time, and the lid was closed to record the time of specimen ex vivo. The body was kept warm and delivered to the laboratory within 30 minutes, and the inspector was provided with the time for specimen removal. Semen routine observation: total semen volume (ml), sperm activity, sperm density (per / ml), semen liquefaction time (time from specimen removal to semen liquefaction), immobile sperm (per / high magnification field), etc.

Seeing immobile sperm, you need to stain to distinguish: inactive sperm, dead sperm, immature sperm, etc.

Sperm can not be found and must be tested after centrifugation. Sperm is still not found; After three sampling tests, sperm could not be found to confirm azoospermia.

Semen routine examination time

Routine semen examination is an important method to evaluate male fertility, and it is also an experimental basis for the diagnosis of male diseases and observation of curative effects. Male semen routine examination results in about 30 to 40 minutes, semen analysis results in about one hour. Males are abstained for five to seven days before the test, and prenatal pregnancy and childbirth tests recommend that both spouses check at the same time.

Reference value for routine semen examination

[Clinical significance]

1. If there is no ejaculation for several days, and the amount of semen is less than 1.5ml, it is abnormal, indicating that the seminal vesicle or prostate has lesions; Specific infections, such as tuberculosis, gonorrhea, and nonspecific inflammation.

2. If the amount of semen is too large (more than 8ml at a time), the sperm is diluted and reduced accordingly, which hinders fertility.

Color check

[Normal reference value]

Gray or milky white, those who have not ejaculated for a long time can be light yellow.

[Clinical significance]

1. Yellow or brown pus-like semen: seen in seminal vesiculitis or prostatitis.

2. Bright red or dark red bloody semen: found in inflammation, tuberculosis and tumors of the reproductive system.

Third, consistency and liquefaction inspection

[Normal reference value]

Viscous jelly, liquefied by itself within 30 minutes.

[Clinical significance]

1. The semen has a low consistency, like rice soup. It can be caused by a decrease in the amount of sperm. It is found in inflammation of the reproductive system. ??

2. Excessive liquefaction time or no liquefaction can inhibit sperm activity and affect fertility, which is common in prostate inflammation.

Fourth, sperm activity rate detection

[Normal reference value]

Normal sperm motility is generally above grade (good activity, moderate-speed movement, but more waveform movement), and within one hour after ejaculation, the ability to move above grade is better than 0.60.

[Clinical significance]

If the level 0 (dead sperm, inability to move, still inactive after warming) and level (poor activity, sperm spinning, shaking or shaking in place, slow movement) sperm above 0.40, it is often important for male infertility one of the reasons.

Five, sperm motility test

[Normal reference value]

30-60 minutes after ejaculation, sperm with a motility of level III or higher> 0.80: 120 minutes after ejaculation, sperm with a motility of level or higher> 0.60; sperm with 0.25-0.60 motility after 120 minutes of ejaculation.

[Clinical significance]

Poor or inactive sperm increase is one of the important causes of infertility. Commonly used in varicocele, non-specific infections of the urogenital system such as E. coli infections, certain metabolites, antimalarials, estrogen, nitric oxide must, etc., can also reduce sperm motility.

Six, sperm count

[Normal reference value]

(100-150) x 109 / L or the total number of ejaculation at one time is (4-6) x 108.

[Clinical significance]

1. Sperm counts less than 20 × 109 / L or a total of one sperm ejaculation are abnormal, which are found in harmful industrial pollution such as varicocele, lead metal, high-dose radiation and the effects of certain drugs.

2. Sperm were not found as spermatozoa in semen for many times, mainly due to low testicular spermatogenesis, congenital vas deferens, seminal vesicle defects, or blocked vas deferens. After 2 months of vasectomy, there should be no sperm in the semen, otherwise the operation fails.

3 The number of spermatozoa of the elderly has gradually decreased since the age of 50 and gradually disappeared.

Seven, sperm morphology examination

[Normal reference value]

Malformed sperm: <10% -15%; Agglutinated sperm: <10%; Immature spermatids: <1%.

[Clinical significance]

1. Abnormal spermatozoa in patients with varicocele, suggesting that sperm have entered the semen when immature, or poor venous return caused excessive temperature in the scrotum and hypoxic testicular tissue, or blood with toxic metabolites reflux from the kidney or adrenal vein To the testis, sperm morphology is impaired for the above reasons.

2. Increased agglomerated sperm in semen, suggesting reproductive tract infection or abnormal immune function. ??

3. When the seminiferous tubules of the testis are affected or injured by drugs or other factors, more pathological immature spermatids can appear in the semen.

Eight, semen cell examination

[Normal reference value]

White blood cells (WBC): <5 cells / HP (high power field of view); red blood cells (RBC): 0-occasional / HP.

[Clinical significance]

1. Leukocytosis in semen is common in seminal vesiculitis, prostatitis, and tuberculosis.

2. Increased red blood cells in semen are common in seminal vesicle tuberculosis and prostate cancer.

3. If cancer cells are found in semen, it has diagnostic significance for germline cancer.

Nine, semen pH (pH) check

[Normal reference value]

7.2-8.0.

[Clinical significance]

1. Semen pH value <7.0, more common in oligospermia or azoospermia, often reflects obstruction of the insemination duct, congenital absence of seminal vesicles, or epididymal lesions.

2. Semen pH> 8.0 is common in acute infections such as seminal vesiculitis and prostatitis.

Ten, determination of male fertility index

[Calculation formula]

I = M (N × V) / (A × 106) where I is the male fertility index; M is the percentage of active sperm; N is the number of sperm per ml; V is the speed of sperm movement; A is the percentage of abnormal sperm .

[Normal reference value]

Normal people fertility index> l.

[Clinical significance]

1. A fertility index of 0 indicates complete infertility.

2. The fertility index is between 0-1, indicating that there are different degrees of fertility disorders.

2. Biochemical and immunological tests:

1. Determination of refined berry sugar

[Normal reference value] 9.11-17.67mmol / L.

[Clinical significance] (1) Semen fructose is 0, which can be seen in the absence of congenital bilateral vas deferens and seminal vesicle glands, complete obstruction or retrograde ejaculation on both sides. (2) Decrease in semen fructose is common in seminal vesiculitis and insufficient androgen secretion. Insufficient fructose can lead to lack of energy for sperm motility and even difficulty in conception.

2. Determination of seminal plasma acid phosphatase

[Normal reference value] King's method:> 255nmol · s-1 / L

[Clinical significance] (1) The content of seminal plasma acid phosphatase is increased, which is common in patients with prostate hypertrophy or early prostate cancer. (2) The content of seminal plasma acid phosphatase is reduced, which is common in patients with prostatitis. (3) Semen acid phosphatase detection is the most sensitive method for forensic identification of semen.

3. Determination of seminal plasma acrosome enzyme activity

[Normal reference value] 36.72 ± 21.43U / L.

[Clinical significance] Sperm acrosome enzyme activity is positively correlated with sperm density and sperm acrosome intact rate, and its lack of activity can cause male infertility.

4. Determination of seminal plasma lactate dehydrogenase-X isoenzyme (LDH-X)

[Normal reference value] LDH-X absolute activity: 2620 ± 1340U / L; LDH-X relative activity: 0.426.

[Clinical significance] LDH-X has the tissue specificity of testes and sperm, and is a key enzyme that excels in exercise capacity. The detection of this enzyme can be a valuable indicator for the diagnosis of male infertility. LDH-X decreases or disappears in patients with testicular atrophy, and no LDH-X is formed when there is a defect in sperm. Those with less or no sperm can cause LDH-X activity to decrease. Taking gossypol can also inhibit this enzyme activity.

5.Determination of seminal carnitine

[Normal reference value] The concentration is 239.56 ± l05.59umol / L.

[Clinical significance] Determination of carnitine in seminal plasma Carnitine in seminal plasma is mainly secreted by the epididymis, followed by seminal vesicles. Carnitine in seminal plasma is divided into two types, free carnitine and acetylcarnitine. The epididymis contains high concentrations of carnitine, which is mainly related to the energy source required by the sperm when the epididymis matures. It is believed that changes in the carnitine and fructose content of seminal plasma often reflect the functions of the epididymis and seminal vesicles. Seminal plasma carnitine and fructose content were normal, indicating normal epididymis and seminal vesicle function. When the carnitine content is higher than normal 50%, and the fructose content decreases, it indicates that the seminal vesicles are dysfunctional and the epididymis function is normal; seminal plasma carnitine is about 50% of the normal content and the fructose content is normal, indicating that epididymal dysfunction and seminal vesicle function Normal; while carnitine decreased sharply, fructose content also decreased, indicating that the seminal vesicle and epididymal function were impaired.

6. Determination of anti-sperm antibody (AsAb)

[Normal reference value] negative.

[Clinical significance] AsAb detection has important clinical significance for examining the cause of infertility. AsAb, which is present in serum or reproductive tract secretion, can inhibit sperm activity, interfere with sperm operation, hinder sperm penetration and sperm-egg binding, and impair fertilization. Even if it has been fertilized, it may affect developing embryos and cause immune miscarriage. Infertile couples account for 25% -30% of AsAb-positive people. When sperm output ducts are blocked, testicular damage, inflammation, epididymis and other germline infections, autoantibodies generated by sperm escape.

Semen routine check for disease problems

How long should I abstain before the test?

Some men need abstinence before the test. For example, before a semen test, it is best to abstain for 3 to 5 days, and the longest should not exceed 7 days. Less than 3 days or more than 7 days will affect the semen results and affect the doctor's judgment and analysis of the disease.

If the abstinence time is not enough, it may not reach the 2 ml or more required for semen collection, and more immature sperm are likely to appear. If abstinence is too long, dead sperm and deformed sperm may increase, and the activity rate may be low.

What are the precautions before the inspection?

First, the patient should stop having sex for 4 to 7 days before semen retention. Testosterone propionate, testosterone phenylacetate and nandrolone phenylpropionate cannot be used 1 week before the test. When taking semen, you can use soft soap or paraffin oil for penis massage and collect the specimens in sterile test tubes. You can also use condoms (rinsed clean, no spermicidal drugs) or use of interrupted sexual intercourse to collect semen. The amount is often small. If no semen can be collected by the above method, the seminal vesicles and the end of the vas deferens can be massaged through the rectum, and urine collection can be performed under pressure to check for sperm in the sediment. Do not expose semen to excessive heat and cold. Refer it to the doctor in time for reference, not more than 30 minutes. Keep warm in cold weather and keep it in your underwear pocket when sending it for inspection.

2. If bacterial culture is to be performed, the urethral orifice should be rinsed and disinfected before collecting the semen in a sterile test tube. A couple who has been living together for more than 3 years and has not taken any contraceptive measures and fails to conceive is called infertility. If it is infertility, you cannot blindly suspect one of the parties before the two sides have performed the test, let alone think that the reason for the infertility is the woman. Pregnancy is a matter for both spouses. To achieve conception, the man's semen content should be normal, and his form and motility should also be normal. The woman can ovulate normally, and the sperm and eggs can be combined into a fertilized egg, which can be planted in the endometrium. Obstacles can occur in any of the above several links, which can cause infertility.

3. If the semen is normal, the woman should also go to the hospital for examination, including general conditions, reproductive organs, ovulation function of the ovary, whether the fallopian tube is unobstructed, and immunological examination. ^[1]