The purpose of this study was to ascertain whether analysis of the physical properties of ejaculate also has any diagnostic potential for evaluating the function of these accessory sex glands. Diverse normal and abnormal states of coagulation, liquefaction, volume, viscosity and pH were studied with regard to the levels of biochemical markers of the seminal vesicles (fructose and inorganic phosphorus) and prostate (calcium, zinc and acid phosphatase). Fructose and inorganic phosphorus were significantly decreased in samples with absent or poor coagulation (p<0.001), volume < 2.0 mL (p=0.009 and p<0.001, respectively), hypoviscosity (p=0.013 and p<0.001), hyperviscosity (p=0.006 and p<0.001) and pH < or = 7.1 (p=0.018 and p<0.001). Also, fructose and inorganic phosphorus were significantly decreased in samples with liquefaction > 120 min (p=0.003) and pH > 8.0 (p<0.001), respectively. Calcium, zinc and acid phosphatase activity were significantly increased in samples with absent or poor coagulation (p<0.001), and significantly decreased in samples with volume > 5.0 mL (p=0.007, p=0.034 and p=0.011) and pH > 8.0 (p<0.001). Also, calcium and zinc were significantly increased in hypoviscous samples (p=0.012 and p=0.003), whereas the zinc concentration was significantly lower in hyperviscous samples (p=0.026). Using receiver operating characteristic (ROC) curve analysis, pH showed the highest predictive power to identify prostate dysfunction (83.6%) and simultaneous prostate and seminal vesicle dysfunction (98.8%). Physical analysis of ejaculate was also found to be clinically useful for evaluating the secretory activity of the seminal vesicles and prostate. Abnormal coagulation, liquefaction, volume, viscosity and pH strongly suggest gland dysfunction.

Background: No reports have been published about age-related sperm malformations in varicocele patients. Aim: To investigate the distribution of abnormal sperm characteristics in adolescents, adults and older men with varicocele. Setting and Design: Records of semen analysis of 143 men aged 14 to 53 years who had evident left-sided varicocele detected by physical examination and confirmed by doppler sonography were selected. Materials and Methods: Sperm concentration, vitality, motility, morphology, hypoosmotic swelling test (HOST) and morphology were measured in adolescent males aged 14 to 20 years (n=31), men 21 to 30 years (n=48), 31 to 40 years (n=40) and older men over 40 (n=24) and compared with a control group of fertile men with no varicocele (n=27) and with a group of infertile men with varicocele (n=26). Statistical Analysis: One-way analysis of variance and the Kruskal-Wallis test were used to compare varicocele groups. Comparisons with the control group and infertile group were performed using the unpaired t-test and the Mann-Whitney test. The discriminating ability of significant sperm characteristics in evaluating the sperm quality of varicocele men was also analyzed using receiver operating characteristics curve to select the cut-off level providing the best combination of sensitivity and specificity. Results: Varicocele men displayed similar impairment of vitality, motility and HOST. Sperm morphology analysis revealed a prevalence of small head, slightly and severely amorphous head and particularly combined anomalies in the study groups. Sperm concentration fell within the normal range of the World Health Organization manual. Differences were not significant between the study groups and when compared with infertile group (P <0.005). However, a comparative study of the varicocele groups and the infertile group with the control group revealed significant differences in sperm vitality, motility, HOST, morphologically normal sperm, pin-headed, tapered and combined anomalies. Morphologically normal sperm and combined anomalies showed higher accuracy in identifying poor sperm quality in varicocele men (83.7% and 77.9%, at cut-off levels of 9% and 38%, respectively). Conclusions: Varicocele harms equally the sperm characteristics of adolescents, adults and older men. Apparently, it affects sperm quality more adversely than it does sperm production.

Aim: To investigate the clinical value of the screening of Ureaplasma urealyticum and Mycoplasma hominis in routine semen analysis. Material and Methods: Semen samples of 234 patients with several clinical settings (infertility, varicocele, spontaneous abortion, genital infections, undescended testicles, hemospermia, etc.) were distributed in three study groups: group 1 -- negative cultures; group 2 – normal colonization (≤10³ colony-forming units (cfu)/ml), and group 3 – pathogenic colonization (>10³ cfu/ml). Frequency rates, incidence by age and clinical settings, association with abnormal sperm characteristics (density, vitality, motility and morphology) and with the leukocyte count were investigated. Results: Prevalence of U. urealyticum was higher than M. hominis (≤10³ cfu/ml: 28.2 vs. 24.8%; >10³ cfu/ml: 20.5 vs. 13.3%). No difference was detected on the incidence of mycoplasmas by age and clinical settings, as well as in regard to the mean values of sperm density, vitality, motility, oval-headed sperm and leukocyte count (p > 0.05). Conclusion: In spite of the high incidence of mycoplasmas, not enough information was available regarding the influence of these microorganisms on the sperm quality and their relationship with the leukocyte count. Therefore, screening of U. urealyticum and M. hominis for routine semen analysis is not clinically relevant.

Aims: To determine the prevalence of Gardnerella vaginalis in semen from infertile men and their negative effects on semen quality. Results: Cultures were positive in 24/108 infertile men (22.2%) and negative in controls. Infected semen showed no significant difference compared with non-infected semen. On the other hand, infected and non-infected semen presented significant differences in vitality, rapid and total progressive motility, normal head and mid-piece defects (p < 0.01) and combined anomalies (p < 0.01 and p = 0.03, respectively) in comparison with the control group. Infected semen also presented significant differences in severely amorphous (p = 0.02) and tapered sperm (p < 0.01). Bacteriospermia and cells with attached bacteria (clue cells morphotype) were remarkable features observed. Conclusion:G. vaginalis in semen is not associated with either abnormal sperm characteristics or inflammatory response in infected men.

A case of an infertile man with bilateral seminal vesicles cysts with ipsilateral renal agenesis is presented with emphasis on the semen analysis. Ejaculates showed very low concentration of fructose, leukocytospermia, teratozoospermia, asthenozoospermia, hyperviscosity, marked sperm agglutination and a poor hypoosmotic swelling test. Clinical value of these findings is discussed.

The spermatozoa were first seen in ejaculates in the 17th century. However, the basic mechanisms of human fertilization have been only fully understood after the discovery of ovum in 1827. As a result, the interest in developing technologies for semen analysis arose from the early 1900s. Indeed, standard methodologies for semen analysis were designed mostly along the first half of the 20th century. Before the 1930s, semen analysis was nearly unavailable clinically, since there were still no robust methodologies for assessing sperm characteristics, as well as to set up standard references that could be able to assess the reproductive capacity of men. However, joining some methodologies reported from 1910 up to 1930, standardization was attained and thereby semen analysis increasingly assumed its role in laboratory practice for investigating men in barren marriage. This article aims in reviewing historical backgrounds on the semen analysis, up to its insertion in laboratory practice. Emphasis is given to the major studies that contributed either directly or indirectly in developing the earliest routine for the semen analysis.

Semen analysis is a basic step in the investigation of several disturbances affecting the male genital tract. Analysis of seminal parameters provides important clinical information on the spermatogenesis and functional competence of spermatozoa, as well as on the secretory pattern of the accessory genital glands. Semen analysis is particularly useful in the evaluation of couples requiring fertility investigation (to detect genital infections and pathologies) and in verifying the influence of environmental factors, drugs, lifestyle, chemical products, and professional activities on several diseases affecting male reproductive health. Measure of semen quality is of substantial interest for diagnoses in clinical urology, andrology, and gynecology. Currently, basic requirements for semen analysis are standardized by World Health Organization (WHO) guidelines that describe several procedures for an objective evaluation of the semen quality with diagnostic purposes. These guidelines include: parameters for the physical and biochemical evaluation of semen; parameters for the analysis of sperm characteristics; and other seminal parameters that can be easily adopted in any laboratory. This report summarizes current concepts on semen analysis and the significance of the seminal parameters for reaching a diagnosis based on the procedures recommended by WHO guidelines.

The relationship between seminal fructose concentration and sperm characteristics was investigated in semens of 187 suspected infertile men without evidence of disturbances in the seminal vesicular function. Sperm density, viability, motility, morphologically oval sperm, and 10 categories of defective spermatozoa (small, large, amorphous, round-head, double-head, pin-head, tapering, mid-piece defects, tail defects, and combined defects) were assessed in 6 levels of seminal fructose concentration, as follows: (1) 0 to 1.0 mg/ml; (2) 1.1 to 2.0 mg/ml; (3) 2.1 to 3.0 mg/ml; (4) 3.1 to 4.0 mg/ml; (5) 4.1 to 5.0 mg/ml; (6) >5.0 mg/ml. None of the sperm characteristics analyzed had shown statistically significant differences among the study groups. It is concluded that seminal fructose levels detected in the routine of semen analysis give no information on the clinical usefulness in defective sperm formation.