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Clinical Atlas of Sperm Morphology
AM Phadke
SECTION 1: CLINICAL ATLAS OF SPERM MORPHOLOGY
CHAPTER 1:
Introduction to Sperm Morphology
DISCOVERY OF HUMAN SPERMATOZOA
INTRODUCTION TO SPERM MORPHOLOGY
GENERAL CONSIDERATIONS
NOMENCLATURE USED IN ANDROLOGY
CHARACTERISTICS AND IMPORTANCE OF SPERM MORPHOLOGY
RELATIVELY STABLE PARAMETER
REFLECTS A COMPREHENSIVE PICTURE OF EVENTS OCCURRING IN THE TESTIS AND EPIDIDYMIS
Testicular Factors
Epididymal Factors
SELECTION OF PHYSIOLOGICALLY MATURE SPERMATOZOA
POST COITAL SPERM MIGRATION
BINDING OF SPERMATOZOA TO THE ZONA PELLUCIDA DURING FERTILIZATION
MORPHOLOGICAL CHARACTERISTICS OF NORMAL SPERMATOZOA
WHO CRITERIA
TYGERBERG STRICT CRITERIA
Method of Study
INDIVIDUALISM IN THE SEMEN PICTURES OF INFERTILE MEN
SPERM MORPHOLOGY AND NATURAL FERTILIZATION
THE STUDY OF SPERM MORPHOLOGY
ERA OF RECORDING OF SPERM ABNORMALITIES
CORRELATION BETWEEN SPERM MORPHOLOGY AND INFERTILITY
Percentage of Abnormal Sperms in Fertile and Infertile Men
The Incidence of Sperms with Normal Morphology in the Semen of Fertile and Infertile Men
Data Obtained from Intrauterine Inseminations
Inputs Received from IVF Results
SPERM MORPHOLOGY AND ACCIDENTS OF PREGNANCIES
CHAPTER 2:
Morphology of Human Spermatozoon
MORPHOLOGY OF HUMAN SPERMATOZOON
HEAD (FIGURES 2.1A AND B)
The Nuclear Characteristics
NECK (FIGURES 2.1A AND B)
MIDDLE PIECE (FIGURES 2.1B AND 2.2A)
PRINCIPAL PIECE (FIGURE 2.2B)
END PIECE (FIGURE 2.2C)
Proximal Centriole and Axis Filament (Figure 2.3)
CHAPTER 3:
Sperm Morphology Classification Systems
SYSTEMS OF CLASSIFICATION OF SPERM MORPHOLOGY
EARLIER SYSTEMS OF SPERM MORPHOLOGY CLASSIFICATION
SUBSEQUENT SYSTEMS OF SPERM MORPHOLOGY CLASSIFICATION
CONTRIBUTION MADE BY ELIASSON
CONTRIBUTION MADE BY DAVID
CONTRIBUTION OF DÜSSELDORF
Elongated Sperm Heads
The Acrosomal Defects
Defects of Sperm Tails
CURRENT SYSTEMS OF SPERM MORPHOLOGY CLASSIFICATION
WHO CLASSIFICATION (1999)
Head Defects
Tail Defects
Important Omissions
Desirable Modifications
TYGERBERG CLASSIFICATION (1990)
Important Shortcomings of Tygerberg Classification
REFERENCE VALUES FOR NORMAL SEMEN (WHO) 1999
CHAPTER 4:
Calculation of Indices and Recording of Sperm Morphology
CALCULATION OF INDICES
The Basic Idea of Indices
Relationship with Infertility
Recording and Reporting of Sperm Morphology
The following abbreviations are used:
For the secondary classification of abnormal forms:
Reporting the Sperm Abnormalities
CALCULATION OF MAI OR TZI
Calculation of SDI
Important Note
DRAWBACK OF THE PRESENT RECORDING SYSTEM OF SPERM MORPHOLOGY
Format for recording the sperm morphology: Manual method
Primary classification: Sperm head defects WHO (1999) As Modified by the author.
CHAPTER 5:
Staining Methods for Sperm Morphology
STAINING METHODS FOR SEMEN SMEARS
FOR SPERM VIABILIY
Stained Preparations
Supravital Staining Methods
Supravital Staining of Cellular Elements in Semen
FOR SPERM MORPHOLOGY
Routine Staining Methods
Eosin-Nigrosin Stain
Hematoxylin and Eosin Stain
Rose Bengal and Toluidine Blue Stain
Papanicolaou Stain
Shorr's Stain
For Leukocytes in Semen
Gimsa Stain
Quick Methods
Diff-Quick Stain
Spermac Stain
Prestained Slides
Testsimplets®
CHAPTER 6:
Introduction to the Pictorial Atlas of Sperm Morphology
SECTION 2: PICTORIAL ATLAS OF SPERM MORPHOLOGY
CHAPTER 7:
Pictorial Atlas of Sperm Morphology
TOPICS
EOSIN-NIGROSIN STAIN
HEMATOXYLIN AND EOSIN STAIN
ROSE BENGAL AND TOLUIDINE BLUE STAIN
PAPANICOLAOU STAIN
SHORR'S STAIN
SUPRAVITAL STAINING OF A SPERMIOPHAGE CELL
SPERMATOZOA UNDER PHASE CONTRAST MICROSCOPE
SPERM HEAD DEFECTS
DEFECTS OF SPERM HEAD
DEFECTS OF SPERM NECK, MIDPIECE AND TAIL.
A NORMAL SPERM
NORMAL SPERMATOZOA
A BORDERLINE SPERM AND A LARGE HEADED SPERM
A LARGE SPERM HEAD
SMALL SPERM HEADS
A TAPERED SPERM HEAD
A PYRIFORM SPERM HEAD
ROUND HEADED SPERMATOZOA
ROUND HEADED SPERMATOZOA WITHOUT ACROSOMES
SPERMATOZOA WITH ROUND HEADS
AMORPHOUS SPERM HEADS
AMORPHOUS SPERM HEADS
AMORPHOUS SPERMATOZOA
AMORPHOUS SPERMATOZOA
A TRINUCLEATE SPERM HEAD
AMORPHOUS AND OTHER SPERM HEADS
AMORPHOUS SPERM HEADS
A TRICEPHALIC SPERM HEAD
A MULTICEPHALIC AMORPHOUS HEAD
AN AMORPHOUS SPERM
AN AMORPHOUS SPERM
A BIZARRE AMORPHOUS SPERM
AN ELONGATED SPERM HEAD
AN AMORPHOUS AND A TAPERED SPERM HEAD
ELONGATED SPERM HEADS
A DUMBBELL SHAPED SPERM HEAD
INCOMPLETE DUPLICATION
NORMAL AND AMORPHOUS SPERMATOZOA
ABNORMAL SPERM HEADS
ABNORMAL SPERMATOZOA
NUCLEAR VACUOLES AND MEGA ACROSOME
NUCLEAR VACUOLES WITH DIADEM DEFECT
DUPLICATE, TAPERED AND DEFECTIVE SPERM HEADS
SPERM HEAD WITH BASAL NUCLEAR VACUOLES
NUCLEAR INVAGINATION AND NUCLEAR VACUOLE
BORDERLINE AND TERATOID SPERMATOZOA
NORMAL AND ABNORMAL SPERMATOZOA
A VACUOLATED SPERM HEAD
A CYTOPLASMIC HOOD COVERING THE SPERM HEAD
A DOUBLE HEADED SPERM
2-B ABNORMALITIES OF SPERM ACROSOMES ADDENDUM
DISCOVERY AND IMPORTANCE OF ACROSOME
ACROSOMAL MORPHOLOGY
BIOCHEMICAL ASPECTS
FUNCTIONAL ASPECTS
ACROSOMAL ABNORMALITIES AS A SEPARATE ENTITY
ACROSOMAL STATUS VIS-Á-VIS INFERTILITY
ACROSOMES OF ABNORMAL SPERMATOZOA
SPERMATOZOA WITH SMALL ACROSOMES
MICROSPERMS WITHOUT ACROSOMES
AN ELONGATED SPERM HEAD WITH SLANTED ACROSOME
LARGE, HYPERTROPHIED AND SHORT ACROSOMES
ACROSOMES OF AMORPHOUS SPERMATOZOA
SPERMATOZOA WITH LATERAL ACROSOMES
AN UMBRELLA TYPE AND NORMAL ACROSOMES
AN EARLY DETACHMENT OF ACROSOME
A SEMI-DETACHED ACROSOME
A SPERM WITH OVERSIZED ACROSOME
A PROTUBERANCE LIKE ACROSOME
THE DIADEM DEFECT
A SPERM HEAD SHOWING DIADEM DEFECT
AN APICAL ACROSOMAL CYST
AN ACROSOMAL CYST AND OTHER ABNORMALITIES
LOCALIZED CONDENSATION OF ACROSOME
A GIANT SPERM HEAD WITH MULTILOCULAR ACROSOME
A MEGALOSPERM WITH RIDGED SPERM HEAD
A ROUND SPERM HEAD WITH CLEFT ACROSOME
DIFFERENT ACROSOMAL DEFECTS
PATCHY ACROSOME AND ACROSOMAL CYST
DISINTEGRATION OF ACROSOME
AN ANOMALOUS DEVELOPMENT OF SPERMATID
SPERM HEADS WITH THICKENED AND ELONGATED NECKS
A SPERM WITH THICKENED NECK AND THIN MIDPIECE
SPERMS WITH BROKEN NECK AND BROKEN MIDPIECE
A KINKED MIDPIECE AND A DETACHED MIDPIECE
A SPERM WITH THICKENED AND IRREGULAR MIDPIECE
ASYMMETRICAL INSERTION OF MIDPIECE
A SPERM WITH THICKENED MIDPIECE AND LONG TAIL
KINKED AND DETACHED MIDPIECES
A GIANT HEAD WITH TWO CURLED TAILS
AMORPHOUS SPERM HEADS WITH TAIL DEFECTS
SPERMATOZOA WITH DOUBLE TAILS AND DETACHED TAIL
A SPERM WITH DOUBLE TAIL
SPERMATOZOA WITH THICK TAILS
A SPERM WITH SEVERE “DAG” DEFECT OF THE TAIL
THE “DAG DEFECT” OF TAIL
MIDPIECE AND TAIL DEFECTS
SPERMATOZOA WITH RUDIMENTARY TAILS
SPERMS WITH NORMAL AND SHORT THICK TAILS
A SHORT TAIL AND A CURLED TAIL
A DOUBLE TAIL WITH A HAIRPIN DEFECT
A CURVED MIDPIECE AND A BENT TAIL
CURLED TAIL AND A HAIRPIN DEFECT OF TAIL
ROLLED TAILS, SHORT TAIL AND HAIRPIN LIKE TAIL
MULTIPLE TAIL ABNORMALITIES
SPERMS WITH TAIL DEFECTS AND A SPERMATID
NORMAL, ABNORMAL SPERMS AND FREE HEADS
CYTOPLASMIC REMNANTS ATTACHED TO THE MIDPIECE
A CYTOPLASMIC MASS ATTACHED TO THE MIDPIECE
IMMATURE SPERM CELL IN A CYTOPLASMIC MASS
TAIL -TO- TAIL TYPE AGGLUTINATION OF SPERMS
PIN HEADED SPERMATOZOA
A BINUCLEATE SPERMATID WITH A TAIL
CHAPTER 8:
Pyospermia
PYOSPERMIA
MEANING AND DEFINITION OF PYOSPERMIA
THE ROLE OF INFECTION IN MALE INFERTILITY
SIGNIFICANCE OF PYOSPERMIA
Is Pyospernia Specific of Male Genital Tract Infections?
Appropriate Culture Tests are Necessary
METHODS USED FOR THE EVALUATION OF PYOSPERMIA
Papanicolaou Stain
Peroxidase Test
Immunohistocytology using Monoclonal Antibodies
Granulocyte Elastase and Cytokine Enzyme Linked Immunoabsorbant Assays
Chemiluminescence Assays
ACTIVATION OF WHITE BLOOD CELLS IN THE MALE GENITOURINARY TRACT
CONSTITUENT CELLS AND THEIR ORIGIN IN PYOSPERMIA
CONFUSION BETWEEN THE INFLAMMATORY CELLS AND THE IMMATURE GERM CELLS
PUS CELLS IN SEMEN
LEUKOCYTES WITH INGESTED SPERM HEAD
SUPRAVITAL STAINING OF PUS CELLS
A MACROPHAGE CELL WITH INGESTED BACTERIA
A MONONUCLEAR MICROPHAGE CELL
A MONONUCLEAR HISTIOCYTE
A BINUCLEATE VACUOLATED MACROPHAGE CELL
A GIANT BUNUCLEATE MACROPHAGE CELL
A GIANT BINUCLEATE SPERMIOPHAGE CELL
A BINUCLEATE SPERMIOPHAGE CELL
A MULTINUCLEATE MACROPHAGE CELL
A DARK TYPE A SPERMATOGONIUM
A DARK TYPE A SPERMATOGONIUM
A PRIMARY SPERMATOCYTE
A RESTING PRIMARY SPERMATOCYTE
A PRIMARY SPERMATOCYTE—ZYGOTENE STAGE
PRIMARY SPERMATOCYTES
SECONDARY SPERMATOCYTES
A MULTINUCLEATE SPERMATID
CHAPTER 9:
Hemospermia
HEMOSPERMIA
IDIOPATHIC OR ESSENTIAL HEMOSPERMIA
SECONDARY HEMOSPERMIA
TRAUMA
BLOOD IN SEMEN
INFLAMMATION
BENIGN OR MALIGNANT TUMORS
CYSTIC LESIONS IN THE GENITOURINARY TRACT
CALCULI IN THE GENITOURINARY TRACT
MISCELLANEOUS LESIONS IN THE GENITOURINARY TRACT
SYSTEMIC DISEASES
INFECTIONS
CHAPTER 10:
Bacteriospermia
BACTERIOSPERMIA
MEANING OF BACTERIOSPERMIA
MICROBES ARE SCARCELY PRESENT IN SEMEN
SIGNIFICANCE OF BACTERIOSPERMIA
INFECTIVE BACTERIOSPERMIA
NON-INFECTIVE BACTERIOSPERMIA
FALLACIOUS BACTERIOSPERMIA
COCCI IN PAIRS SEEN IN A SEMEN SMEAR
COCCI IN PAIRS AND CHAINS IN A SEMEN SMEAR
A BUNCH OF SPHERICAL CELLS IN A SEMEN SMEAR
PRESENCE OF COCCI AND BACILLI IN A SEMEN SMEAR
SECTION 3: APPENDICES
APPENDIX I:
Staining Methods Used in the Atlas: A Critical Appraisal
STAINING METHODS FOR SPERM VIABILITY
METHODS THAT USE TWO STAINS
Reagents
Procedure
Results
METHODS THAT USE A SINGLE STAIN:
Reagents
Procedure
Results
Reagents
Procedue 1
Results
Procedure 2
Results
METHODS THAT USE A COMBINED STAIN
Reagents
Procedure
Results
SUPRAVITAL STAINING OF CELLULAR ELEMENTS IN SEMEN
APPENDIX II:
Preparation of a Smear
METHOD OF PREPARATION OF THIN SMEAR
APPENDIX III:
Papanicolaou Staining Procedure for Sperm Morphology WHO (1999) and Mortimer (1994)
APPENDIX IV:
de Neef-Pundel Modification of Shorr Stain
APPENDIX V:
Rose Bengal and Toluidine Blue Staining Method for Sperm Morphology (Invented by the Author)
APPENDIX VI:
Hematoxylin and Eosin Staining Method
INDEX
TOC
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