Who laboratory manual 2010

WHO laboratory manual for the

Examination and processing of human semen
FIFTH EDITION

WHO laboratory manual for the

Examination and processing of human semen
FIFTH EDITION

WHO Library Cataloguing-in-Publication Data WHO laboratory manual for the examination and processing of human semen - 5th ed. Previous editions had different title : WHO laboratory manual for the examination ofhuman semen and sperm-cervical mucus interaction. 1.Semen - chemistry. 2.Semen - laboratory manuals. 3.Spermatozoa - laboratory manuals. 4.Sperm count. 5.Sperm-ovum interactions - laboratory manuals. 6.Laboratory techniques and procedures - standards. 7.Quality control. I.World Health Organization.

ISBN 978 92 4 154778 9

(NLM classification: QY 190)

© World Health Organization 2010 Allrights reserved. Publications of the World Health Organization can be obtained from WHO Press, World Health Organization, 20 Avenue Appia, 1211 Geneva 27, Switzerland (tel.: +41 22 791 3264; fax: +41 22 791 4857; e-mail: bookorders@who.int). Requests for permission to reproduce or translate WHO publications— whether for sale or for noncommercial distribution—should be addressed to WHO Press, at theabove address (fax: +41 22 791 4806; e-mail: permissions@who.int). The designations employed and the presentation of the material in this publication do not imply the expression of any opinion whatsoever on the part of the World Health Organization concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers orboundaries. Dotted lines on maps represent approximate border lines for which there may not yet be full agreement. The mention of specific companies or of certain manufacturers’ products does not imply that they are endorsed or recommended by the World Health Organization in preference to others of a similar nature that are not mentioned. Errors and omissions excepted, the names of proprietary products aredistinguished by initial capital letters. All reasonable precautions have been taken by the World Health Organization to verify the information contained in this publication. However, the published material is being distributed without warranty of any kind, either expressed or implied. The responsibility for the interpretation and use of the material lies with the reader. In no event shall theWorld Health Organization be liable for damages arising from its use. Printed in Switzerland. Cover photo: courtesy of C. Brazil

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CONTENTS
Acknowledgements Acronyms and abbreviations used in this manual xi xiii

Chapter 1
1.1 1.2 1.3

Background
Introduction The fifth edition Scope of the manual

1
1 1 3

PART I.
Chapter 2
2.1 2.2 2.2.1 2.2.2 2.2.3 2.2.4 2.2.5 2.2.6 2.2.7 2.32.3.1 2.3.2 2.3.3 2.3.4 2.3.5 2.4 2.4.1 2.4.2 2.4.3 2.4.4 2.4.5 2.5 2.5.1 2.5.2 2.5.3 2.5.4 2.6 2.6.1 2.6.2 2.6.3 2.7 2.7.1 2.7.2 2.7.3 2.7.4 2.7.5 2.7.6

SEMEN ANALYSIS
Standard procedures
Introduction Sample collection Preparation Collection of semen for diagnostic or research purposes Sterile collection of semen for assisted reproduction Sterile collection of semen for microbiologicalanalysis Collection of semen at home Collection of semen by condom Safe handling of specimens Initial macroscopic examination Liquefaction Semen viscosity Appearance of the ejaculate Semen volume Semen pH Initial microscopic investigation Thorough mixing and representative sampling of semen Making a wet preparation Aggregation of spermatozoa Agglutination of spermatozoa Cellular elements other thanspermatozoa Sperm motility Categories of sperm movement Preparing and assessing a sample for motility Worked examples Lower reference limit Sperm vitality Vitality test using eosin–nigrosin Vitality test using eosin alone Vitality test using hypo-osmotic swelling Sperm numbers Types of counting chamber The improved Neubauer haemocytometer Using the haemocytometer grid Care of the counting chamber...