Limitations of semen analysis as a test of male fertility and anticipated needs from newer tests
Semen analysis is the cornerstone for the diagnosis of male factor infertility. Routine semen analysis cannot assess spermatozoal fertilizing potential. New tests should predict the outcome of assisted reproduction and risks to progeny.
Christina Wang, M.D., Ronald S. Swerdloff, M.D.
Volume 102, Issue 6, Pages 1502-1507
Semen analysis is the first step to identify male factor infertility. Standardized methods of semen analysis are available allowing accurate assessment of sperm quality and comparison among laboratories. Population-based reference ranges are available for standard semen and sperm parameters. Sperm numbers and morphology are associated with time to natural pregnancy, whereas sperm motility may be less predictive. Routine semen analysis does not measure the fertilizing potential of spermatozoa and the complex changes that occur in the female reproductive tract before fertilization. Whether assisted reproduction technology (ART) is required depends not only on male factors but female fecundity. Newer tests should predict the success of fertilization in vitro and the outcome of the progeny.