scholarly journals Semen analysis: update on clinical value, current needs and future perspectives

Reproduction ◽  
2013 ◽  
Vol 146 (6) ◽  
pp. R249-R258 ◽  
Author(s):  
Victoria Sánchez ◽  
Joachim Wistuba ◽  
Con Mallidis

At present, evaluation of male reproductive function consists primarily of routine semen analysis, a collection of conventional microscopic assessments ideally performed following the guidelines set by the World Health Organization. While providing some insight into testicular function, these long-performed tests are limited in the information that they impart; more specifically, they are unable to predict true fertility potential. As a consequence, there is a need for the appraisal and consideration of newer semen parameters that may be more indicative of reproductive success. Although various novel assays have been introduced that broaden the scope of information available to both researcher and clinician, the utility of these tests remains limited due to the lack of standardisation of protocols and the absence of clinically established, dependable reference ranges. As such, it is not surprising that most of these parameters and their associated methods remain recommended for ‘research purposes only’. With the burgeoning ‘omics’ revolution, nanotechnology and the development of new analytical instruments, there is now an opportunity for the identification and measurement of previously unknown features that may prove to be more indicative of each sperm's true functional status and capability. Once optimised, simplified, clinically validated and made more readily accessible, these new approaches hold the promise of forming the fulcrum upon which andrological investigations can enter a new era.

2015 ◽  
Vol 172 (6) ◽  
pp. 669-676 ◽  
Author(s):  
Anne-Laure Barbotin ◽  
Caroline Ballot ◽  
Julien Sigala ◽  
Nassima Ramdane ◽  
Alain Duhamel ◽  
...  

ObjectiveAlthough an inhibin B assay may be useful in the assessment of testicular function in a number of genital conditions, reliable reference ranges are still lacking. The present study sought to establish the reference range for serum inhibin B by applying the updated Gen II assay.DesignThis prospective study included 818 men referred for semen analysis: 377 were normozoospermic (reference group) and 441 presented at least one abnormal semen parameter (case group).MethodsSemen parameters were interpreted according to the 2010 World Health Organization manual and David's modified classification for normal morphology. The inhibin B concentration was determined with the current ELISA.ResultsIn the reference group, the 2.5th percentile for inhibin B was 92 pg/ml and the 97.5th percentile for FSH was 7.8 IU/l. In the overall population, an inhibin B level <92 pg/ml was associated with increased odds ratio (OR; 95% CI) for oligozoospermia (16.93 (9.82–29.18), P<0.0001), asthenozoospermia (4.87 (2.88–8.10), P<0.0001), and teratozoospermia (2.20 (1.31–3.68), P=0.0026). The combination of a FSH >7.8 IU/l and an inhibin B <92 pg/ml was associated with greater OR for oligozoospermia (98.74 (23.99–406.35), P<0.0001) than for each hormone considered separately.ConclusionsA new reference range for serum inhibin B was established by the use of updated immunoassay. The correlations between hormone levels and semen parameters highlighted the importance of establishing these values with respect to the spermogram. When combined with FSH assay, the inhibin B range may be of value in the evaluation of spermatogenesis in a number of male genital conditions.


2022 ◽  
Vol 71 (6) ◽  
pp. 2224-27
Author(s):  
Aysha Khan ◽  
Zunera Shahbaz ◽  
Shagufta Yousaf ◽  
Abeera Ahmed ◽  
Fatima Sana ◽  
...  

Objective: To study the patterns and distribution of various abnormal semen parameters in infertile males. Study Design: Cross sectional study. Place and Duration of Study: Department of Pathology, Combined Military Hospital, Karachi, from Nov 2019 to Oct 2020. Methodology: The study included 364 patients who presented with primary and secondary infertility. Consecutive convenient sampling was done. Semen analysis was performed using World Health Organization latest guidelines. Samples were categorized as normospermia, azoospermia, oligospermia, asthenozoospermia and necrospermia. Results: The study comprised of 364 samples of infertile males. Normal sperm count was observed in 317 (87%) males, azoospermia in 28 (7.6%) and oligospermia in 19 (5.2%) males. Low ejaculated volume and higher non-motile sperms were noted in oligospermia samples in comparison with normospermia samples. Asthenozoospermia was observed in 102 (28%) and oligoasthenospermia was noted in 15 (4.1%) samples. Conclusion: Good quality semen analysis is a corner stone to diagnose the cause of male infertility.Sperm concentration and motility are the important markers of normal male reproductive system and are related to each other.


2016 ◽  
Vol 23 (05) ◽  
pp. 589-596
Author(s):  
Haroon Latif Khan ◽  
Yousaf Latif Khan ◽  
Irfan Mehfooz ◽  
Muhammad Burhan ◽  
Saba Sardar ◽  
...  

Semen is a pale whitish fluid secreted by male during ejaculation and containsspermatozoa which are male gametes essential of fertilizing the oocytes which are femalegametes. In a quest to evaluate male’s fertility potential semen is analyzed to look into some ofits characteristics and of the sperms contained within the semen analyzed. Method of collectioninfluences the results of Semen analysis as does the technique of analysis. Spermatozoa areexamined for number (count), shape (morphology) and movement (motility) in order to assesstheir quality. Non sperm cells, volume, Fructose level, pH, liquefaction are also checked asa part of routine analysis. Objectives: To describe the pattern of semen parameters in subfertilemales. To look into frequency and distribution of abnormal semen parameters in a groupof Pakistani males in Lahore. Methods: In this Retrospective, cross sectional, observationalstudy all males undergoing for evaluation and treatment for sub-fertility at a private AssistedReproductive Technology clinic in Lahore, Pakistan were included. Approval of the IRB wassought and data collection instrument was a specially designed Performa which was validatedby the biostatistician of LIFE research cell. Data was extracted from the files of LIFE (LahoreInstitute of Fertility and Endocrinology) and entered in SPSS version 15. Sampling techniquewas non-probability, consecutive. Semen analysis was done by methods defined by the WHO(World Health Organization). Results: Of total patient (n=679) 92.2% (626) males passed sampleat LIFE (Lahore institute of fertility and endocrinology) and (7.8%) 53 brought sample fromhome. Of the males who passed sample at LIFE (78.8%) 535 collected semen by masturbation,(11.9%) 81 by coitus; the source of sample of (9.3%) 63 males was not known. As 2-6 ml semenwas consider to be normal by WHO criteria, (80.6%) 547 males were in normal range (14.1%)96 found to be less than 2-6 ml and (5.3%) 36 found to be more than normal range. Accordingto WHO criteria 15 million/ml count is said to be normal, in our research (82.0%) 557 were foundto be normal, in (2.9%) 20 count was found to be less than 15 million/ml and in (5.9%) 40 countwas less than 1 million/ml. In (9.1%) 62 counts was found to be abnormally low. In this research(66.1%) 449 had normal sperm motility, (21.8%) 148 had less than 40% and abnormally lowsperm motility was found in (12.1%) 82 males. Conclusion: The results of the single semenanalysis are of limited utility and no decision should be taken on the bases of these results interm of diagnosis and treatment strategies.


2018 ◽  
Author(s):  
Jessica R Zolton ◽  
Alan H. DeCherney

In 2009, the World Health Organization formally recognized infertility as a disease of the reproductive system. This designation serves to ease access to infertility evaluation and treatment. Infertility is a disease of both men and women, and proper evaluation of both partners is necessary. Common causes of infertility are ovulatory dysfunction, tubal and pelvic pathology, unexplained infertility, and male factor. A complete history and physical examination may uncover the underlying etiology, although verification of tubal patency and normal semen analysis is warranted. This period also offers an opportunity to perform preconception testing and optimize women’s health before conception. Treatment for infertility is aimed to restore normal reproductive function and anatomy. In addition, patient education and counseling is indeed a very important aspect of infertility care. This review contains 5 figures, 5 tables and 60 references Key Words: anovulation, Antimullerian hormone, antral follicle count, hysterosalpingogram, infertility, infertility evaluation, ovarian reserve testing, polycystic ovarian syndrome, saline infusion sonohysterography


2018 ◽  
Vol 43 (2) ◽  
pp. 94-100
Author(s):  
Md. Selim Morshed ◽  
AKM Khurshidul Alam ◽  
AKM Anwarul Islam ◽  
Sojib Bin Zaman ◽  
Mohammad Saruar Alam ◽  
...  

Prevalence of varicocele is approximately 15.1% of the general population. Studies showed that surgical correction of clinically palpable varicocele could improve the semen parameters. However, there is scarce of study to demonstrate post-operative outcome of varicocelectomy among the patients with abnormal semen parameter. Therefore, this study tried to compare the microscopic changes in sperm concentration, sperm motility, and sperm morphology before and after varicocelectomy. This quasi-experimental study was done in Urology Department of Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh from November 2014 to April 2016. Forty five patients with clinically palpable varicocele were finally includedin the study. Semen parameters of these patients were assessed by following the World Health Organization′s 5th manual of semen parameter, 2010. Subinguinal varicocelectomy was performed in every case. Follow up was done three months and six months after surgery. Data were analysed with statistical software SPSS 20 and level of significance was assessed by paired t-test.Almost 60.0% of patients were from 25 to 35 years age group. Of them, 87.1% patients were presented with left-sided varicocele, and 80% were grade III. All the patients showed oligospermia on semen analysis, whereas the number of abnormal sperm motility and abnormal morphology was 39, and 09, respectively. After surgical correction of varicocele, mean improvement of sperm concentration, motility and morphology found in 35 patients (77.7%), 31 patients (79.4%) and six patients (66.6%) respectively. The improvement was statistically significant (p<0.05). This study showed that surgical treatment could lead to the betterment of semen parameters in patients with clinically palpable varicocele, which will guide in deciding the management of varicocele patients presented with abnormal semen parameter. However, to recommend varicocelectomy as a most useful procedure in treating infertility cases; further longitudinal studies are recommended to establish the impact of varicocelectomy on


2019 ◽  
Vol 14 (2) ◽  
Author(s):  
Nahid Punjani ◽  
Madhur Nayan ◽  
Keith Jarvi ◽  
Kirk Lo ◽  
Susan Lau ◽  
...  

Introduction: We aimed to study the association of ethnicity on semen parameters and hormones in patients presenting with infertility. Methods: Data from men presenting for infertility assessment were prospectively collected and retrospectively reviewed. Demographic and clinical history was self-reported. Semen analysis included volume, count, motility, morphology, and vitality. The 2010 World Health Organization cutoffs were used. Baseline total testosterone and follicle-stimulating hormone (FSH) levels were recorded. Ethnicity data was classified as Caucasian, African-Canadian, Asian, Indo-Canadian, Native-Canadian, Hispanic, and Middle Eastern. All patients with complete data were included and statistical analysis was performed. Results: A total of 9079 patients were reviewed, of which 3956 patients had complete data. Of these, 839 (21.2%) were azoospermic. After adjusting for age, African-Canadians (odds ratio [OR] 1.70; 95% confidence interval [CI] 1.28‒2.25) and Asians (1.34; 95% CI 1.11‒1.62) were more likely to be azoospermic compared to Caucasians. Similarly, African Canadians (OR 1.75; 95% CI 1.33‒2.29) were more likely to be oligospermic and Asians (OR 0.82; 95% CI 0.70‒0.97) less likely to be oligospermic. Low volume was found in African-Canadian (OR 1.42; 95% CI 1.05‒1.91), Asians (OR 1.23; 95% CI 1.01‒1.51), and Indo-Canadians (OR 1.47; 95% CI 1.01‒2.13). Furthermore, Asians (OR 0.73; 95% CI 0.57‒0.93) and Hispanics (OR 0.58; 95% CI 034‒0.99) were less likely to have asthenospermia. Asians (OR 0.73; 95% CI 0.57‒0.94) and Indo-Canadians (OR 0.58; 95% CI 0.35‒0.99) were less likely to have teratozospermia. No differences were seen for vitality. No differences were seen for FSH levels, however, Asians (p<0.01) and Indo-Canadians (p<0.01) were more likely to have lower testosterone. Conclusions: Our study illustrates that variations in semen analyses and hormones exist in men with infertility. This may provide insight into the workup and management for infertile men from different ethnicities.


1992 ◽  
Vol 1 (2) ◽  
pp. 151-164 ◽  
Author(s):  
Susan M Avery

Male infertility, while having a variety of causes, is generally discussed in terms of semen parameters. While the World Health Organization (WHO) have been able io set limits for semen parameters below which a male can be considered subfertile (20 million/ml; >50% motility; >50% morphologically normal forms), it is well documented thatin vivoconceptions have been achieved where semen quality falls well outside these limits, and that infertile men may have normal semen parameters. Macleod and Gold in comparing 1000 fertile men and 1000 infertile men, found that significantly more infertile men had sperm densities below 20 million/ml, but also that 60% of infertile men had sperm densities of 60 million or more. Jouannet and Feneaux have shown that the conception ratein vivoonly apparently falls significantly at sperm concentrations of less than five million/ml. Although the cause of subnormal semen analysis is unknown in the majority of cases, there is no reason to suppose that abnormal semen parameters on their own are the cause of infertility. Rather the problem may be caused by failure of sufficient numbers of sperm traversing the female tract and reaching the oocyte. Unfortunately, lack of defined diagnoses lead to a lack of direct treatment for subnormal semen parameters. The development ofin vitrofertilization (IVF) resulted in a method that could be used to circumvent the problem since it requires relatively low numbers of sperm and these are placed in the immediate vicinity of the oocyte. It should also be pointed out that normal semen parameters do not imply fertility, since these parameters cannot directly identify dysfunction. IVF offers the advantage that sperm-oocyte interractions can be observed, and in cases of fertilization failure, the point at which sperm dysfunction manifests itself may potentially be identified – if not the nature of the dysfunction. Techniques have now been developed that may overcome certain types of dysfunction, using both biochemical and mechanical means.


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