Microscopic examination of the ejaculate

Preparation of native preparations of ejaculate

Not later than 1 hours after ejaculation liquefied ejaculate thoroughly mixed, avoiding foaming. A drop of semen is applied to clean, dry objective glass, warmed to 20-25 ° C, covered with a cover, TEN track, that between the panes do not end air bubbles, and study the native drug under a microscope at 200X magnification or 400 X.

The morphology of the elements of the ejaculate

The sperm in the ejaculate

Sperm - The predominant elements of the ejaculate. They are long cells (58-67 M) with zhgutikami. They are three parts: head, neck and tail.

Golovko sperm oval, flattened anteroposteriorly, with a pointed front end. Most of the head is occupied by the kernel, chromatin which comprises 23 chromosome. The cytoplasm surrounds the nucleus in the form of a thin shell.

Neck - The most delicate part of the sperm. Tail sperm and thin, length 50-60 mm.

In the absence of sperm in the ejaculate native preparation is centrifuged at 3000-4000 rev / min for 5-10 minutes. From sediment preparing native medicines and examine them under a microscope, establishing the presence or absence of sperm or cells of spermatogenesis, the average count in the same field of view, the nature of mobility. In the presence of sperm preparations dried, stained and examined spermogrammu.

In various diseases of sexual glands (prostatitis and so on.) may occur agglutination of spermatozoa in native specimens, which is estimated as follows::

gluing unit spermatozoidov- " ";

Only half of the sperm heads - " ";

half of the sperm head and, and tails - " ";

almost all the sperm - " ".

Supporting cells convoluted seminiferous tubules (Sertoli cells) rare (in 5 % All ejaculates).

The cells in the ejaculate of spermatogenesis

The cells of spermatogenesis (spermatogonia, spermatocitы, spermatydы) in a normal ejaculate up 0.5 2 %. A large number observed in the secretory infertility.

Red blood cells in the ejaculate

Red blood cells normally absent or occur in a preparation unit. In wounds, inflammatory and other pathologies can be found a large number of red blood cells - gemospermiya.

White blood cells in the ejaculate

In a normal ejaculate contains individual leukocytes. A large number of white blood cells in the ejaculate - piospermiya - Observed in tuberculosis, gonorrhea, as well as non-specific inflammation of the seminal vesicles, prostate, etc.. When piospermii shows staining smears for Gram and Ziehl-Nelsenu. In a study of male infertility is mandatory crop ejaculate to identify its microflora and to determine its sensitivity to antibiotics.

When detected in the ejaculate a considerable amount of white blood cells, erythrocytes and other pathological elements must perform detailed analysis of the ejaculate. More than 90 % men have the following sequence of the component highlight when ejaculation:

• preeyakulyatornaya fraction contains the secret of the bulbourethral and paraurethral glands, It contains spermatozoa;
• ejaculatory first fraction contains the secret of the prostate gland and sperm from the vas deferens, ampoule;
• ejaculatory second fraction contains the sperm from the vas deferens and epididymis tail and a mixture of the secrets of the prostate and seminal vesicles;
• in the third fraction ejaculatory sperm are virtually absent, It contains a secret seminal vesicle.

Given these data, You can set or is likely to assume the presence of a source of red blood cells in the ejaculate, leukocytes and other pathological impurities, a portion, having the highest number of active-motile sperm, used for conjugal artificial insemination.

Epithelial cells in the ejaculate

In a normal ejaculate can be found in small amounts columnar epithelium of the deep portions of the urethra and epididymis duct, and prostate epithelium (rarely).

In inflammatory processes of the prostate epithelium can be detected in the ejaculate in a significant number of small round cells with marked whitish steatosis. Such cells are arranged separately and in groups, often forming a disintegrating leukocytes shapeless mass, among which can be distinguished only separate distinct cell.

The epithelium of the seminal vesicles often contains dark inclusions.

When pathological processes can be hard to exfoliate skin cells, which normally are not found in the ejaculate. So, in non-specific urethritis in ejaculate fall into a significant number of cells from the scaphoid fossa of urethra (stratified squamous epithelium with signs of proliferation, degeneration and keratinization), and at gonorrhoeal and traumatic epididymitis - from upstream areas ejaculatory tract - the epididymis.

Giant multinucleated cells of foreign bodies in the ejaculate

Giant multinucleated cells of foreign bodies, or chronic inflammation cells, have a diameter of up to 50 m or more, rounded, contain 6 to 30 more monomorphic, randomly arranged nuclei. The nucleoli are not always expressed. Basophilic cytoplasm, clearly defined, may contain small inclusions.

Macrophages in эyakulyate

Macrophages in the ejaculate have different sizes. A characteristic feature is the presence of different inclusions in the cytoplasm. Macrophages, phagocytic sperm, have a diagnostic value, They referred to as spermatofahamy. This large round cells in diameter 20-36 mm with light, often vacuolated cytoplasm and one or more cores. In the cytoplasm of the cells can be studied sperm head phagocytized. On the periphery spermatofagov often seen protruding tails of sperm.

Macrophages are found in inflammatory processes, and sperm- tofagi - often at a standstill ejaculate different origin (long-term abstinence, obliteration of the vas deferens and other).

With secret prostate ejaculate fall acellular elements - crystals Böttcher, grain lipids (letsitinovye grains), amyloid corpuscles (concretions).

Grains of lipids in the ejaculate

Corn lipids - a small round shape matte Education. In normal ejaculate contains a significant amount. If prostatitis their number decreases, sometimes up to complete disappearance.

Crystals Böttcher

Böttcher colorless crystals, elongated, are formed during cooling and drying of the ejaculate, Lugol staining solution in a dark-blue color. The more pronounced Parvisemia, more rapidly and in greater numbers, these crystals formed, their appearance is especially true for prostatitis.

Amyloid corpuscles

Amyloid corpuscles - Education oval shape with a characteristic layered structure, yellow color. The central part of them can be fine. Are formed at a standstill prostatic secretions.

Mucus in the ejaculate

Mucus in the normal ejaculate is absent. When the prostate or vesicles ejaculate gets a large amount of thick sticky mucus, which envelops the sperm and is responsible for their immobility.

If microscopy of a native preparation leukocytes, erythrocytes, cells of spermatogenesis, agglutination, grain lipids, amyloid corpuscles is expressed in one field of view. If necessary, all of the elements of the ejaculate counted, as the sperm, chamber Goryaeva, allowing the clinician to evaluate the effectiveness of the treatment of inflammatory diseases of male genital organs.