AAB HCLD Andrology questions and answrs(latest upate).

Abstinence for SA A minimum of 48 hours but not longer than 7 days. sperm agglutination (WHO 5th) Grade 1: isolated (<10 per agglutination) Grade 2: 10-50 Grade 3: >50 Grade 4: All Grade A: Head to head Grade B: tail to tail Grade C: Tail-tip to tail-tip Grade D: Mixed Grade E: Tangle Sperm Concentration and Count Hemocytometer: 1:20 dilution, count twice from 5 squares (4 corners + 1 center). Total avg number = 10^6/ml. Makler's: Load 5-10ul, count sperm in 10 squares, Conc=countx10^6/ml. Polyzoospermia >250x10^6/ml Kruger strict sperm morphology 2-3um x 3-5 um head, <1 um wide, 1.5X head long neck, 45 um tail. Post-Vas SA should be done 2 months later after 10 ejaculation. Considered "Sterile" when 2 SA, 1 month apart, are negative for presence of sperm. Cervical mucus evaluation Need to be done as close as to ovulation. 1. Amount (0=0ul, 1=100ul, 2=200ul, 3=300ul or more) 2. Viscosity (0=thick, very viscous; 1=intermediate; 2=mildly viscous; 3=watery) 3. Ferning (check multiple field and take the highest: 0= no crystal; 1=atypical fern formation; 2=primary and secondary ferning; 3=tertiary and quaternary ferning) 4. Spinnbarkeit: Stretchiness. 0=<1cm; 1= 1-4cm; 2=5-8cm; 3=9cm or more) 5. Cellularity: 0=>20cells/hpf; 1=11-20; 2=1-10; 3=0) Total >10 is favoring sperm penetration <10 in unfavorable Cervical mucus PH Optimum is 7.0 to 8.5. 6.0 to 7.0 still considered compatible. postcoital test (Sims-Huhner test) examines the interaction between sperm and cervical mucous; sperm agglutination, and reduced motility suspicious for antisperm antibodies. 9-24h after coitus. popular test but not standardized. One abnormal has limited clinical value. The slide test (Kurzrok-Miller test) semen---mucus(cover slip)---semen Normal result: Sperm penetrate into mucus and >90% are motile Poor: Sperm penetrate. But not >500um (about 10 sperm lenghts) Abnormal: No penetrate. Count sperm first HPF and second HPF Excellent: =>25 sperm/hpf (F1 and F2) Good: 15 in F1 and 10 in F2 Poor: 5 in F1 and 0 to 1 in F2 Negative: no penetration in F1 and F2 Sperm-cervical mucus contact (SCMC) test Detect anti-sperm antibody by mixing the sperm and mucus. If antibody presents, the motile sperm will become "shaking" sperm. Negative: 0-25% shaking Weakly Positive: 26-50% Positive: 51-75% Strongly positive: 76-100% Can use donor mucus and sperm to help identify the source of Ab. False positive almost always mucus factor. The capillary tube test (Kremer Test) Tube filled with mucus with one end sealed. The opened end was placed into semen. 37C for 1 to 2 hours. Normal: Sperm travels >20 cm Abnormal: <6cm