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Chapter 19 - Evaluating Defects in Sperm Function

from Section 3 - Laboratory Diagnosis of Male Infertility

Published online by Cambridge University Press:  08 July 2023

By
Christopher J. De Jonge
Edited by
Larry I. Lipshultz ,
Stuart S. Howards ,
Craig S. Niederberger  and
Dolores J. Lamb
Larry I. Lipshultz
Affiliation:
Baylor College of Medicine, Texas
Stuart S. Howards
Affiliation:
University of Virginia
Craig S. Niederberger
Affiliation:
University of Illinois, Chicago
Dolores J. Lamb
Affiliation:
Weill Cornell Medical College, New York
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Summary

Semen analysis has been the standard of clinical laboratory assessment(s) of male fertility potential for more than 70 years [1–4]. Methodologies for performing the semen analysis, along with standard practices to ensure quality in clinical laboratory practices throughout testing, have been codified in multiple World Health Organization publications [5–9]. A common, and albeit disappointing, conclusion regarding the semen analysis is that the lower reference limits have limited predictive value for fertility or, for that matter, infertility (see, for example, [10–14]). A partial explanation for this inadequacy is that, with the exception of sperm motility, sperm function requirements that are necessary for successful fertilization and term delivery are not assessed in the semen analysis. This dilemma impacts the ability of clinicians to provide an evident diagnosis to the patient couple concerning the presence/absence of male subfertility, especially in the absence of genetic, hormonal, or urogenital abnormalities. This dilemma becomes further exacerbated for the clinician who must decide on an appropriate therapeutic strategy to address the infertility and for the patients who balance their desires in conjunction with spiritual, emotional, and financial considerations.

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Infertility in the Male , pp. 363 - 380
Publisher: Cambridge University Press
Print publication year: 2023

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