Other Parameters
August 20th, 2005Whereas the count, motility, and morphology of the specimen constitute the major parameters on which the male's fertility is categorized, there are other characteristics of the semen that may impact on fertility potential. A volume of less than 1 mL may be too little to make contact with the cervix, and a volume greater than 7 mL may dilute the sperm concentration so that insufficient numbers are in close proximity to the cervix.
Round cells in the specimen can be either white cells or immature cells. The WHO standards manual states that a normal ejaculate should not contain any more than 5 million round cells per mL (5 per high power field) while the number of leukocytes should not exceed 1 million per mL. There are staining methods, biochemical tests, and immunologic techniques to differentiate immature cells from white cells, but these tests are not commonly performed. In most laboratory reports all round cells are lumped together as white blood cells. It is reasonable to obtain a culture, perhaps by prostatic massage, when the report states that there are 5 or any more white cells per high power field, even though some of these may be immature cells.
Repetitive agglutination of sperm (except when it is on pieces of debris) is suggestive of an immunologic effect or an infection. It may, however, be nonspecific and of no significance. Although it is common practice to evaluate the pH of semen because abnormalities may provide a clue to disorders of the accessory glands, in practice this measurement is of little value.
