Macroscopic Examination

LIQUEFACTION

• Freshly ejaculated semen sample is usually in the form of thick coagulum. This is because of the enzyme protein kinase secreted by seminal vesicles.
• Slowly the coagulum starts dissolving. This process is called Liquefaction.
• Liquefaction is usually completed within 15-30 min.
• Liquefaction is because of the enzyme fibrinolysin secreted by the prostate gland.
• Delayed liquefaction (>60 min.) is because of prostatic dysfunction.
• The specimen container is placed on the bench or in an incubator (37 °C) for liquefaction.
• Liquefaction of the semen is assessed after 60 min.

INFERENCE	TIME
Proper	< 60 min.
Improper	>60 min. (sperms may be trapped in unliquefied jelly; maybe sign of prostatic infection, or lack of prostatic protease.)

APPEARANCE

• Hold the jar up to look through its bottom
• Note the following:

Grayish oplusent	Normal
Yellowish	Presence of infection  Jaundice  Taken Antibiotics
Reddish	Presence of RBC’s

ODOUR

• Different people have different abilities to smell semen, so this cannot be standardized.
• However, when the lid is taken off the collection jar, it should be noted if there is a strong smell of urine or of  putrefaction.
• Samples collected after a prolonged abstinence period (i.e. several weeks) are likely to have a stronger odour.

VOLUME

• This is most easily assessed using a warmed sterile volumetric pipette.

1.5 to 5 ml.	Normal Volume
< 1.5 ml.	Hypospermia ( it will affect the sperm motility assessment )
>5 ml.	Hyperspermia ( it will affect the sperm count assessment )

• A post ejaculatory urine analysis to look for retrograde ejaculation is indicated when ejaculate volume is less than 1 ml, except in the case of-
  • Hypogonadism
  • Congenital bilateral absence of vas deference, 
  • collection problems or
  • Less abstinence period. 

VISCOSITY

Normal	Sample falls drop by drop from pipette (or) form thread less than 2 cm.
Viscous	Sample forms more than 2 cm thread

• High viscosity impedes sperm movement and interferes with the assessment of  -
  • sperm motility
  • sperm concentration 
• If semen is viscous, we have to do mechanical mixing with the help of 21 G needle, before assessment.

ph

• The pH of liquefied semen is normally determined using pH test strips 
• Put a drop of semen evenly onto the pH paper.
• Wait for the colour of the impregnated zone to become uniform (<30 seconds).
• Compare the colour with the calibration strip to read the pH.

Normal	7.2 to 7.8
Acidic	Less than 7.0

An acidic pH suggests problems with seminal vesicle function , and is usually found in association with a low volume of the ejaculate and the absence of fructose.