From published evidence we are reasonably certain that the number, motility and morphology of sperm are important for a either natural or assisted conception. The conflicting evidence surrounding parameters such as DNA fragmentation or antisperm antibodies suggests that the testing procedures to measure these are subject to a higher level of ‘uncertainty’.
Evidence demonstrating Uncertainty associated with semen analysis
- Changing clinical thresholds or reference ranges over the past 25 years (WHO, 1987, 1992, 1999, 2001).
- A litany of publications questioning the clinical value of semen analysis.
- Considerable variation in clinical practice in relation to treatment decision making based on sperm quality.
- EQA data (UKNEQAS and American Association of Bioanalysts National Proficiency testing, Keel et al 2000).
- Failure to establish consensus regarding the clinical significance or indeed the reference ranges for certain tests e.g. antisperm antibodies, DNA fragmentation (Barratt et al, 2010; Tomlinson et al, 2013).
- Lack of automation in semen analysis in comparison to other areas of pathology.
Uncertainty in Diagnostic Semen Analysis: Part 1
Uncertainty in Diagnostic Semen Analysis: Part 2
Source: Embryo news
Image credits: Malpani Infertility Clinic
Art and Science of Laboratory Medicine