Uncertainty in Diagnostic Semen Analysis

Uncertainty in relation to laboratory testing simply means the existence of doubt or level of error associated with a particular measurement. In general, if the evidence relating any given semen parameter with pregnancy outcome is weaker or controversial then it is likely that: either the study design was not particularly robust or the testing method used to measure that particular semen parameter is subject to a higher level of uncertainty.

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.

Read more:
Uncertainty in Diagnostic Semen Analysis: Part 1
Uncertainty in Diagnostic Semen Analysis: Part 2

Source: Embryo news
Image credits: Malpani Infertility Clinic

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