Microscopic examination of seminal fluid

Microscopic examination of the ejaculate is carried out after its full dilution;study the native preparation, count the number of spermatozoa in the Goryaev chamber and analyze the stained smear. When studying the native preparation, the motility of spermatozoa is determined. Spermatozoa are counted in the following order.

■ Active-mobile: performing translational motion and crossing the field of view of the microscope in less than 1 s;in the norm they are more than 50%.

■ Inactive: with slow motion;in the norm they are less than 50%, as well as with a riding, oscillatory or pendulum-like movement( less than 2%).

■ Stationary;are normally absent.

The study of the native preparation gives an approximate idea of ​​the number of spermatozoa. When counting spermatozoa in Gorirayev's chamber, their amount is determined in 1 ml of ejaculate and in all the material obtained. Normally, a healthy man in 1 ml of ejaculate contains more than 20 million spermatozoa, and in all isolated ejaculate - more than 80 million. Reducing the number of spermatozoa less than 20 million in 1 ml of ejaculate is regarded as an oligozoospermia( grade I - 10-19 million in 1 ml, II - less than 10 million in 1 ml).

Pathological forms of spermatozoa are also found in Goryaev's chamber, their content does not normally exceed 40%.On average, normal sperm in sperm of 81% are normal sperm, 15% of spermatozoa have pathology in the head region, 2% - neck pathology, 2% - pathology of the tail [Evdokimov V.V.and others, 1995].The increase in the ejaculate of immobile( dead) spermatozoa is called necrozoospermia.

Cells of spermatogenesis, which are normally represented by spermatids, are found in each ejaculate. Their content in sperm does not exceed 2-4%;an increase of up to 10% or more indicates a violation of spermatogenesis.

Increase in the content of ejaculate pathological forms of spermatozoa - teratospermia. Pathological forms include spermatozoa with huge heads, with two heads, with two tails, without a tail, with a thickened deformed body, with a deformed neck, with a tail curled around the head, with a noose in the upper third of the tail. Teratospermia dramatically reduces the possibility of fertilization, and if it occurs, increases the possibility of developmental malformations in the fetus. Teratospermia is usually combined with a decrease in the number of spermatozoa and their mobility. Complete absence of spermatozoa in the preparation - azoospermia. If no spermatozoa or cells of spermatogenesis are detected in the ejaculate in question, ascites are detected. This pathology is associated with deep suppression of spermatogenesis( atrophy of the seminal epithelium in the convoluted tubules, thickening of the basal membrane or their hyalinization, absence of hypophyseal goatnotropins in the body).

In the study of the native preparation, sometimes agglutination is detected - the formation of clusters of spermatozoa, glued together by heads or tails. In normal ejaculate, spermatozoa do not agglutinate. You can not take for agglutination a chaotic conglomeration, the accumulation of spermatozoa and their ability to accumulate around lumps of mucus, cells, detritus, this phenomenon is called "pseudoagglutination."Agglutination is caused by the appearance of anti-spermatozoa, its degree is evaluated as follows:

■ weak - single spermatozoa are glued in the native preparation;

■ medium - glued up to 50% of spermatozoa, but only in the head region;

■ strong - spermatozoa are glued together with heads and tails;

■ mass - almost all spermatozoa are glued together.

The study of the morphology of spermatogenesis cells, their differentiation with leukocytes is carried out in a colored preparation. In ejaculate normally contains 4-6 white blood cells in the field of vision;an increase in their content( as a consequence of inflammation) is called pyospermia.

Erythrocytes are usually absent. The appearance in the ejaculate of erythrocytes - hemospermia - is observed with varicose veins of seminal vesicles, stones in the prostate gland, papilloma of the seminal vesicle and neoplasms.

Lipoid bodies( lecithin grains) - a product of secretion of the prostate gland. In normal ejaculate contained in large quantities.