This part should be completed by the TRAINEE
DATE OF TRAINING STARTED: TRAINEE NAME :
SECTION :
Training Method

Explanation Lectures

Demonstration

Practice

Computer based

Self study
Training Materials

SOP

Manuals

Package Inserts

Lecture Hand outs

Computer Program Handouts

Videotape (s)

Practice materials
Yes
Yes
No
No
Read the following
Reference/ SOP SOP No. Date Completed Trainee Initials
Semen Analysis
Training Element
I.
Samples
1.
1 Abstinence period
2.
Semen sample collection instructions
3.
Transport temperature
4.
Semen collection procedure for microbiological analysis
II.
Procedures
1.
Macroscopic Examination a.
Liquefaction

Liquefaction time
 macroscopic and microscopic recognition of liquefied and unliquefied semen

Semen treatment if it doesn't liquefy within 60 minutes of collection
Read &
Understood
Discussed Observed Performed
Proficiently
Training and Competency Assessment Program/ Training ULC/TCP/11F
Training checklist for Semen Analysis Version 1
Effective Date: 25 October, 2011 Page 1 of 4

Training Element b.
Viscosity

Criteria for evaluating semen viscosity

Interferences due to high semen viscosity c.
Normal and abnormal appearance of semen d.
Volume

Measurement procedure

Clinical significance of abnormal volume

Normal Range e.
pH

Measurement procedure

Clinical significance of abnormal pH

Normal Range
2.
Microscopic Examination a.
The use of phase contrast microscope b.
The use of total magnification of ×100 c.
The use of total magnification of x400 d.
The procedure for making wet preparation e.
Causes and effects of inhomogeneous semen sample f.
Aggregated and agglutinated spermatozoa g.
Types of agglutination (degree and attachment sites) h.
Sperm Motility

Categories of sperm movement

Preparing and assessing a sample for motility

Criteria for accepting or rejecting sperm motility result.

Comparison of replicate percentage

Calculating the total number of progressively motile sperms
Sperm numbers

Determining the required dilution

Fixative for diluting semen
 haemocytometer loading procedure

The improved Neubauer haemocytometer

Thickness of the used cover slip

Counting procedure
 spermatozoa to count in the grid squares

Assessing sperm numbers in the counting chambers

Calculating the concentration of spermatozoa per ml.

Calculating the total number of spermatozoa per ejaculate

When an accurate assessment of low sperm numbers is not required

Examination of centrifuged samples to detect spermatozoa

Examination of non-centrifuged samples to detect motile spermatozoa
Read &
Understood
Discussed Observed Performed
Proficiently
Training and Competency Assessment Program/ Training ULC/TCP/11F
Training checklist for Semen Analysis Version 1
Effective Date: 25 October, 2011 Page 2 of 4

Training Element Read &
Understood

When an accurate assessment of low sperm numbers is required Calculation of low concentrations of spermatozoa in semen
3. Counting of cells other than spermatozoa

Assessment of leukocytes in semen

Staining cellular peroxidase using ortho -toluidine

Principle

Reagents

Procedure

Assessing peroxidase-positive cell number in the haemocytometer chambers

Calculation of the concentration of peroxidase-positive cells in semen

Reference value
III.
Quality Control
1.
1 Quality control procedures
Results Interpretation and Reporting
Discussed Observed Performed
Proficiently
1.
Reference Ranges for all parameters
2.
Results Interpretation and Reporting
VI. Preventive maintenance
1. Cleaning and disinfecting the haemocytometer and the cover slip
IV.
Safety Measures
1. Safety measures as explained by MSDS for chemicals
This form should be completed by the TRAINER
Trainee Performance Evaluation Method Yes No
Result Of Evaluation
Satisfactory Un
Satisfactory

Oral evaluation

Direct observation competency (If yes, complete the form)

Written competency

Unknown samples (If yes, include a copy of the result)

Other
Corrective Action If Needed
DATE OF TRAINING COMPLETED : ……………………………
TRAINEE SIGNATURE
TRAINER SIGNATURE
SUPERVISOR SIGNATURE
DATE
: ……………………………..
: ……………………………..
: ……………………………..
: ……………………………..
Training and Competency Assessment Program/ Training ULC/TCP/11F
Training checklist for Semen Analysis Version 1
Effective Date: 25 October, 2011 Page 3 of 4

Training and Competency Assessment Program/ Training ULC/TCP/11F
Training checklist for Semen Analysis Version 1
Effective Date: 25 October, 2011 Page 4 of 4