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Practical
Laboratory Andrology
David
Mortimer, Ph.D.
Oxford
University Press, New York, 1994
ISBN 0-19-506595-6
This
practical manual on sperm analysis presents the diagnostic and therapeutic
procedures that are used in andrology laboratories to analyze and
assess male infertility. Diagnostic areas include: semen analysis
and the biochemical, immunological and microbiological examination
of human semen and spermatozoa; computer-aided sperm motility analysis;
sperm ultrastructure; and assessment of sperm transport through
the female reproductive tract and sperm fertilizing ability. The
clinical relevance of the various diagnostic procedures is also
discussed. Therapeutic topics include sperm washing techniques,
semen cryopreservation, and insemination procedures. The volume
also covers safety in the andrology laboratory, technician training
and quality control.
The
text is extensively illustrated and will be an invaluable resource
to all scientists and technicians working in the diagnosis of male
infertility. It will also be of interest to researchers working
in human gamete biology and reproductive physiology. The detailed
methods described in the book are relevant to all hospital, commercial,
and university laboratories involved in infertility diagnosis and
treatment. Each Chapter has a list of references and recommended
reading.
Table
of Contents
Introduction
|
Conventions
used in this book |
|
Concepts
of fertility, infertility and sterility |
|
Defining
normal ranges |
|
Terminology
used by andrologists |
Sperm physiology
| |
Sperm
production: testis; epididymis; accessory glands |
| |
Ejaculation
and insemination |
| |
Spermatozoon:
sperm morphology and morphometry; sperm motility |
| |
Sperm
transport in the female tract: spermatozoa in the vagina;
spermatozoa in the cervix; “rapid” sperm transport, spermatozoa
in the uterus; isthmic sperm reservoir |
| |
Gamete
interaction and fertilization: capacitation; acrosome reaction;
physiological regulation of sperm fertilizing ability; sperm-egg
interaction; sperm-oocyte fusion and syngamy |
Semen analysis
|
General
principles: patient instructions; sample collection; split
ejaculates; liquefaction; mixing |
|
Physical
characteristics: appearance; liquefaction and viscosity;
odor; ejaculate volume; semen pH |
|
Assessment
of the wet preparation: sperm motility; sperm aggregation
and agglutination; other cellular components and debris |
|
Identification
of leukocytes in semen: peroxidase staining using benzidine-cyanosine;
peroxidase staining using o-toluidine blue; immunocytochemical
identification |
|
Sperm
concentration: hemocytometry; specialized counting chambers |
|
Sperm
vitality, integrity and longevity: sperm vitality assessment
using eosin-nigrosin; sperm vitality assessment using the H33258
fluorochrome; sperm osmotic fragility: the hypo-osmotic swelling
test; sperm longevity assessments |
|
Sperm
morphology: Papanicolaou staining; Bryan-Leishman staining;
Shorr staining; sperm morphology classification systems |
Biochemistry
of spermatozoa and seminal plasma
| |
Biochemistry
of spermatozoa: acrosin; ATP content; chromatin condensation
assessments; creatine kinase content; glutamic-oxaloacetic transaminase;
hyaluronidase; lactate dehydrogenase isozymes; nuclear chromatin
decondensation test; reactive oxygen species production; malonaldehyde
production |
| |
Biochemistry
of seminal plasma: acid phosphatase; carnitine; citric acid;
fructose: quantitative analysis; fructose: spot test; -glucosidase;
glycerophosphocholine; magnesium; prostaglandins; zinc |
Antisperm
antibodies
| |
Mechanisms
of action |
| |
Diagnostic
tests for antisperm antibodies: overview; spermagglutinating
antibody titration: the Friberg test; spermotoxic antibody detection/titration;
direct Immunobead test; indirect Immunobead test |
| |
Clinical
application |
Semen microbiology
and virology
| |
Pyospermia |
| |
Microbiological
examination of semen: collection of semen specimens; examination
of ejaculate |
| |
Organisms
found in human semen: Ureaplasma and Mycoplasma; Chlamydia;
Neisseria gonorrhoeae; other organisms; viruses |
| |
Infection
control and semen donors: initial screening; repeat screening;
each ejaculate; actions for positive tests |
Computer-aided
sperm analysis and sperm kinematics
| |
Limitations
of CASA technology: fundamental principles of digital image
analysis; sources of error in CASA systems |
| |
Application
of CASA systems to semen analysis: validation of CASA semen
analysis results; possible solutions to problems of CASA |
| |
Sperm
kinematics: sperm movement characteristics; methods of measuring
sperm movement; basic principles of sperm kinematics |
Ultrastructure
of spermatozoa
|
Electron
microscopy of human spermatozoa: scanning electron microsocpy;
transmission electron microscopy; surface replica preparations |
|
Preparation
of human spermatozoa for electron microscopy: TEM: thin
sections; TEM: surface replicas; SEM |
Assessment
of sperm transport
|
Cervical
mucus sampling and assessment: timing the procedure; sampling
cervical mucus; assessment of cervical mucus quality: the Insler
score; measurement of cervical mucus pH; storage of cervical
mucus |
|
In
vitro sperm-mucus interaction tests: background; Kremer
test; Kurzrok-Miller test; sperm-cervical mucus-contact test;
crossed-hostility testing; mucus substitutes |
|
In
vivo sperm-mucus interaction testing: background; post-coital
test |
|
Sperm
transport in vivo: background; laparoscopic sperm recovery |
Sperm fertilizing
ability testing
|
Sperm
migration testing: hyaluronate migration test |
|
Assessment
of capacitation: sperm surface lectin labelling; chlortetracycline
fluorescence; hyperactivated motility |
|
Assessment
of the acrosome reaction: triple-stain technique; fluorescent
lectin labelling; acrosome reaction induction protocols |
|
Assessment
of sperm-zona pellucida binding: hemizona assay; competitive
zona binding test; fluorescent labeling of living human spermatozoa;
competitive sperm-zona binding test procedure; expression of
zona binding test results; recovering zonae pellucidae from
human ovarian tissue; salt storage of human zonae pellucidae |
|
Zona-free
hamster egg penetration test: overview; recommended sperm
preparation protocol; preparation of fresh zona-free hamster
eggs; preparation of cryopreserved zona-free hamster eggs; gamete
coincubation conditions; reading the HEPT; cryopreservation
of zona-intact hamster eggs |
|
Comprehensive
sperm function testing protocol |
Clinical
relevance of diagnostic procedures
|
Semen
analysis: extrinsic effects; aspects of sperm quality; relationships
with fertility |
|
Antisperm
antibodies: effects of ASABs in men; effects of ASABs in
women; prevalence and significance of ASABs |
|
Sperm-cervical
mucus interaction testing: post-coital test; in vitro tests |
|
Sperm
migration tests |
|
Zona-free
hamster egg penetration test: HEPT and in vivo conception;
HEPT and IVF; influence of HEPT methodology; future use of HEPT |
|
Sperm-zona
pellucida binding tests |
|
Sperm
acrosome reaction assessments |
|
Sperm
movement analysis and CASA: semen analysis; sperm kinematics
and SMIT results; sperm kinematics and HEPT; sperm hyperactivation;
sperm kinematics and IVF |
|
Laparoscopic
sperm recovery |
|
Evaluation
of a sperm function test |
Sperm washing
|
Yield
calculations: relative yield; absolute yield; yield quality |
|
Culture
media for human spermatozoa: preparation of HTF culture
medium |
|
Dilution
and washing techniques |
|
Migration
techniques: swim-up from semen; swim-up from a washed pellet;
swim-up from a washed sperm preparation; swim-down migration;
SpermSelect; combined migration-sedimentation; trans-membrane
migration; migration across meshes |
|
Selective
washing techniques: Percoll; Nycodenz |
|
Adherence
methods: glass wool column filtration; glass beads; Sephadex
columns |
|
Clinical
applications: sperm washing and microbiology; choice of
sperm washing method; viscous semen samples; stimulation of
sperm motility |
Therapeutic
insemination procedures
|
Sperm
preparation for therapeutic insemination procedures: sterile
technique; protein supplementation of culture media; sperm preparation
techniques |
|
Retrograde
ejaculation: retrograde ejaculation evaluation |
|
Pericervical
insemination |
|
Intrauterine
insemination |
|
Gamete
intrafallopian transfer |
|
Intraperitoneal
insemination |
|
Insemination
of human oocytes in vitro |
|
Mechanically
assisted fertilization |
|
Treatment
of antibody-coated spermatozoa: attempts to reduce ASAB
binding to spermatozoa; attempts to separate antibody-free spermatozoa;
attempts to remove ASABs from the sperm surface; clinical treatment
of ASABs |
Semen cryopreservation
|
Historical
perspectives |
|
Clinical
applications: semen autoconservation; donor semen cryopreservation |
|
Technical
background: cryoprotectants; interindividual variability;
packaging; cryopreservation; inventory control systems |
|
Cryopreservation
of human semen: glycerol-egg yolk-citrate method; other
cryoprotectant media recipes |
|
Organization
of a sperm bank |
|
Transportation
of cryopreserved semen |
Safety in
the andrology laboratory
|
Basic
laboratory safety: accident prevention; protective clothing
and equipment; fire safety; hazardous chemicals; radioactive
materials; compressed gases |
|
Cryogenics |
|
Infection
control: specific recommendations |
|
Implementation
of laboratory safety |
|
Conclusions |
Technician
training and quality control aspects
|
Technician
training: goal-oriented training scheme for semen analysis |
|
Quality
control and quality assurance: basic concepts; quality control
of semen analysis |
|
Conclusions |
Appendices
|
Semen
analysis procedural schedule and sample laboratory form |
|
Microscope
field calibration |
|
Epifluorescence |
|
Sample
antisperm antibody laboratory report form |
|
Sample
donor screening forms |
|
Sample
sperm-mucus interaction testing laboratory and report forms |
|
Semen
cryopreservation forms |
|
Equipment
required for a basic andrology laboratory |
Index
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