Skip to main content Accessibility help

We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Close this message to accept cookies or find out how to manage your cookie settings.

Close cookie message
×
Hostname: page-component-586b7cd67f-gb8f7 Total loading time: 0 Render date: 2024-11-26T23:00:02.900Z Has data issue: false hasContentIssue false

Chapter 20 - The Modern Semen Analysis

Theory and Techniques of Ejaculate Examination

from Section 4 - Laboratory Evaluation and Treatment of Male Infertility

Published online by Cambridge University Press:  06 December 2023

By
Lars Björndahl
Edited by
Douglas T. Carrell ,
Alexander W. Pastuszak  and
James M. Hotaling
Douglas T. Carrell
Affiliation:
Utah Center for Reproductive Medicine
Alexander W. Pastuszak
Affiliation:
University of Utah
James M. Hotaling
Affiliation:
Utah Center for Reproductive Medicine
Get access

Summary

The examination of the human ejaculate constitutes a complicated branch of medical laboratory science. To understand the complexity of the human ejaculate knowledge about the physiology and pathology is facilitating. It is also essential to understand that the main value of ejaculate examination is the information that can be obtained on the functional capacity of the male reproductive organs. Still, the main focus has for a long time only been on the prognostic value for the outcome of the fertility of the couple. In this chapter the focus is on how the functional capacity of the male reproductive trace can reflect in the ejaculate examined in the laboratory. Important principles for reliable laboratory techniques for ejaculate volume, sperm concentration and sperm count, sperm motility, sperm vitality, and sperm morphology are described with requirements for reliability, assessment of uncertainties, need for staff training, internal quality control, and interlaboratory comparisons (external quality control).

Keywords

semenejaculate evaluationmale reproductionfertility
Type
Chapter
Information
Men's Reproductive and Sexual Health Throughout the Lifespan
An Integrated Approach to Fertility, Sexual Function, and Vitality
 , pp. 159 - 164
Publisher: Cambridge University Press
Print publication year: 2023

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Barratt, CLR, Björndahl, L, De Jonge, CJ, et al. The diagnosis of male infertility: an analysis of the evidence to support the development of global WHO guidance – challenges and future research opportunities. Hum Reprod Update. 2017;23:660–680.Google Scholar
Keel, BA. How reliable are results from the semen analysis? Fertil Steril. 2004;82:41–44.Google Scholar
Björndahl, L, Barratt, CL, Mortimer, D, Jouannet, P. ‘How to count sperm properly’: checklist for acceptability of studies based on human semen analysis. Hum Reprod (Oxford). 2016;31:227–232.Google Scholar
van Leeuwenhoek, A. Observationes D. Anthonii Lewenhoeck, de natis’e semine genitali animalculis. Philos Trans R Soc Lond B Biol Sci. 1677;12:1040–1046.Google Scholar
Harvey, C, Jackson, MH. Assessment of male fertility by semen analysis – an attempt to standardise methods. Lancet. 1945:99–104.Google Scholar
MacLeod, J, Hotchkiss, RS. The distribution of spermatozoa and of certain chemical constituents in the human ejaculate. J Urology. 1942;48:225–229.Google Scholar
MacLeod, J. The male factor in fertility and infertility; an analysis of ejaculate volume in 800 fertile men and in 600 men in infertile marriage. Fertil Steril. 1950;1:347–361.Google Scholar
MacLeod, J, Gold, RZ. The male factor in fertility and infertility. IV. Sperm morphology in fertile and infertile marriage. Fertil Steril. 1951;2:394–414.Google Scholar
MacLeod, J, Gold, RZ. The male factor in fertility and infertility. II. Spermatozoon counts in 1000 men of known fertility and in 1000 cases of infertile marriage. J Urology. 1951;66:436–449.Google Scholar
MacLeod, J, Gold, RZ. The male factor in fertility and infertility. III. An analysis of motile activity in the spermatozoa of 1000 fertile men and 1000 men in infertile marriage. Fertil Steril. 1951;2:187–204.Google Scholar
MacLeod, J. The biochemistry of the human male genital tract. Int Rec Med Gen Pract Clin. 1951;164:671–673.Google ScholarPubMed
MacLeod, J. Effect of chickenpox and of pneumonia on semen quality. Fertil Steril. 1951;2:523–533.CrossRefGoogle ScholarPubMed
MacLeod, J. Semen quality in 1000 men of known fertility and in 800 cases of infertile marriage. Fertil Steril. 1951;2:115–139.Google Scholar
MacLeod, J. Sulfhydryl groups in relation to the metabolism and motility of human spermatozoa. J Gen Physiol. 1951;34:705–714.CrossRefGoogle Scholar
MacLeod, J, Gold, RZ. The male factor in fertility and infertility. V. Effect of continence on semen quality. Fertil Steril. 1952;3:297–315.Google Scholar
MacLeod, J, Gold, RZ. The male factor in fertility and infertility. VI. Semen quality and certain other factors in relation to ease of conception. Fertil Steril. 1953;4:10–33.Google Scholar
MacLeod, J, Gold, RZ. The male factor in fertility and infertility. VII. Semen quality in relation to age and sexual activity. Fertil Steril. 1953;4:194–209.CrossRefGoogle Scholar
Gold, RZ, Macleod, J. The male factor in fertility and infertility. VIII. A study of variation in semen quality. Fertil Steril. 1956;7:387–410.Google Scholar
MacLeod, J, Gold, RZ. The male factor in fertility and infertility. IX. Semen quality in relation to accidents of pregnancy. Fertil Steril. 1957;8:36–49.CrossRefGoogle ScholarPubMed
Eliasson, R. Analysis of semen. In: Behrman, SJ, Kistner, RW, eds. Progress in Infertility. Little, Brown and Co; 1975:691–713.Google Scholar
Eliasson, R. Semen analysis and laboratory workup. In: Cockett, ATK, Urry, RL, eds. Male Infertility Workup, Treatment and Research. Grune & Stratton; 1977:169–188.Google Scholar
Eliasson, R. Analysis of semen. In: Burger, HG, De Kretser, DM, eds. The Testis. Raven Press; 1981:381–399.Google Scholar
Arver, S, Kvist, U, Bjorndahl, L. In memoriam: Rune Eliasson MD, PhD. Andrology. 2020;8:530–531.Google Scholar
Mortimer, D. Laboratory standards in routine clinical andrology. Reprod Med Rev. 1994;3:97–111.CrossRefGoogle Scholar
Mortimer, D. Practical Laboratory Andrology. Oxford University Press; 1994.CrossRefGoogle Scholar
Björndahl, L, Barratt, CL, Fraser, LR, Kvist, U, Mortimer, D. ESHRE Basic Semen Analysis Courses 1995–1999: immediate beneficial effects of standardized training. Hum Reprod (Oxford). 2002;17:1299–1305.Google Scholar
Barratt, CL, Björndahl, L, Menkveld, R, Mortimer, D. ESHRE Special Interest Group For Andrology Basic Semen Analysis Course: a continued focus on accuracy, quality, efficiency and clinical relevance. Hum Reprod (Oxford). 2011;26:3207–3212.Google Scholar
Mortimer, D, Björndahl, L, Barratt, CLR, et al. A Practical Guide to Basic Laboratory Andrology. 2nd ed. Cambridge University Press; 2022.Google Scholar
Belsey, M, Eliasson, R, Gallegos, AJ, Moghissi, KS, Paulsen, CA, Prassad, AMN. Laboratory Manual for the Examination of Human Semen and Semen-Cervical Mucus Interaction. Press Concern; 1980.Google Scholar
World Health Organization. WHO Laboratory Manual for the Examination of Human Semen and Semen-Cervical Mucus Interactions. 2nd ed. Cambridge University Press; 1987.Google Scholar
World Health Organization. WHO Laboratory Manual for the Examination of Human Semen and Sperm-Cervical Mucus Interactions. 3rd ed. Cambridge University Press; 1992.Google Scholar
World Health Organization. WHO Laboratory Manual for the Examination of Human Semen and Sperm-Cervical Mucus Interactions. 4th ed. Cambridge University Press; 1999.Google Scholar
World Health Organization. WHO Laboratory Manual for the Examination and Processing of Human Semen. 5th ed. World Health Organization; 2010.Google Scholar
World Health Organization. WHO Laboratory Manual for the Examination and Processing of Human Semen. 6th ed. World Health Organization; 2021.Google Scholar
Eisenberg, ML, Li, S, Behr, B, et al. Semen quality, infertility and mortality in the USA. Hum Reprod (Oxford). 2014;29:1567–1574.Google Scholar
Punjabi, U, Spiessens, C. Basic Semen Analysis Courses: experience in Belgium. In: Ombelet, W, Bosmans, E, Vandeput, H, Vereecken, A, Renier, M, Hoomans, E, eds. Modern ART in the 2000s: Andrology in the Nineties. The Parthenon Publishing Group; 1998:107–113.Google Scholar
Vreeburg, JTM, Weber, RFA. Basic Semen Analysis Courses: experience in the Netherlands. In: Ombelet, W, Bosmans, E, Vandeput, H, Vereecken, A, Renier, M, Hoomans, E, eds. Modern ART in the 2000s: Andrology in the Nineties. The Parthenon Publishing Group; 1998:103–106.Google Scholar
Mortimer, D, Shu, MA, Tan, R. Standardization and quality control of sperm concentration and sperm motility counts in semen analysis. Hum Reprod (Oxford). 1986;1:299–303.Google Scholar
Cooper, TG, Neuwinger, J, Bahrs, S, Nieschlag, E. Internal quality control of semen analysis. Fertil Steril. 1992;58:172–178.CrossRefGoogle ScholarPubMed
Cooper, TG, Björndahl, L, Vreeburg, J, Nieschlag, E. Semen analysis and external quality control schemes for semen analysis need global standardization. Int J Androl. 2002;25:306–311.Google Scholar
Björndahl, L. What is normal semen quality? On the use and abuse of reference limits for the interpretation of semen analysis results. Hum Fertil (Camb). 2011;14:179–186.CrossRefGoogle ScholarPubMed
Pound, N, Javed, MH, Ruberto, C, Shaikh, MA, Del Valle, AP. Duration of sexual arousal predicts semen parameters for masturbatory ejaculates. Physiol Behav. 2002;76:685–689.Google Scholar
Amann, RP. Considerations in evaluating human spermatogenesis on the basis of total sperm per ejaculate. J Androl. 2009;30:626–641.Google Scholar
Björndahl, L, Kvist, U. Sequence of ejaculation affects the spermatozoon as a carrier and its message. Reprod Biomed Online. 2003;7:440–448.Google Scholar
Björndahl, L, Kvist, U. A model for the importance of zinc in the dynamics of human sperm chromatin stabilization after ejaculation in relation to sperm DNA vulnerability. Syst Biol Reprod Med. 2011;57:86–92.Google Scholar
Eisenberg, ML, Walsh, TJ, Garcia, MM, Shinohara, K, Turek, PJ. Ejaculatory duct manometry in normal men and in patients with ejaculatory duct obstruction. J Urology. 2008;180:255–260; discussion 60.CrossRefGoogle ScholarPubMed
Björndahl, L. Semen characteristics and aging: technical considerations regarding variability. In: Carrell, D, ed. Paternal Influences on Human Reproductive Success. Cambridge University Press; 2013:183–190.Google Scholar
Cooper, TG, Brazil, C, Swan, SH, Overstreet, JW. Ejaculate volume is seriously underestimated when semen is pipetted or decanted into cylinders from the collection vessel. J Androl. 2007;28:1–4.Google Scholar
Björndahl, L, Mortimer, D, Barratt, CLR, et al. A Practical Guide to Basic Laboratory Andrology. Cambridge University Press; 2010.Google Scholar
Mortimer, D. A technical note on the assessment of human sperm vitality using eosin-nigrosin staining. Reprod Biomed Online. 2020;40:851–855.Google Scholar

Save book to Kindle

To save this book to your Kindle, first ensure [email protected] is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats
×