The Effect of the New 2010 World Health Organization Criteria for Semen Analyses on Male Infertility

Capsule:
Fifteen percent of men with previously abnormal semen analysis would be reclassified as normal by the 2010 WHO criteria. This may lead to less male infertility diagnosis or evaluation.

Authors:
Katie S. Murray, D.O., Andrew James, M.D., James B. McGeady, M.D., Michael L. Reed, Ph.D., Wayne W. Kuang, M.D., Ajay K. Nangia, M.B.B.S.

Volume 98, Issue 6, Pages 1428-1431, December 2012

Abstract:

Objectives:
To quantify the effect of the new 2010 World Health Organization (WHO) semen analysis reference values on reclassifying previous semen analysis parameters and definition of patients with male factor infertility.

Design:
A multi-institutional retrospective chart review.

Setting:
University and private male infertility clinics.

Patients:
Men referred for infertility evaluation.

Intervention:
To compare semen analysis values based on 2010 versus 1999 reference criteria.

Main Outcome Measures:
Quantification of the change based on individual sperm parameters and as a whole.

Results:
184 men had at least 2 semen analyses. 13 (7%), 17 (9.2%), 34 (18.4%), and 29 (15.7%) patients changed classification to being at or above the reference value by the 2010 criteria for semen volume, sperm concentration, motility, and morphology respectively. 501 men had one semen analysis on file. 40 (7.9%), 31 (6.2%), 50 (9.9%), and 74 (19.3%) would change classification for volume, concentration, motility, and morphology respectively. Overall, 103 (15.1%) patients who had one or more parameter below the reference value on the original analysis was converted to having all parameters at or above the 2010 reference values.

Conclusions:
The 2010 reference values will result in some infertile men being reclassified as fertile if status is based upon semen analysis alone. This may lead to fewer men referred for proper infertility evaluation or treatment.

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