Semen analysis: its place in modern reproductive medical practice

Semen analysis is the most important laboratory investigation for men when assessing the infertile couple. Advances in in vitro fertilisation (IVF) techniques, particularly intracytoplasmic sperm injection (ICSI) involving the direct injection of a single spermatozoon into an egg, have not diminished the role of semen analysis in modern reproductive practice. Semen analysis is the most basic laboratory investigation undertaken and is descriptive in terms of semen volume, appearance, viscosity, sperm concentration, sperm motility and morphology. Since the results are used by clinicians to choose appropriate treatment options, a reliable service is imperative. It is crucial that the laboratory is experienced in the performance of semen analyses to ensure an accurate result. To ensure a quality semen analysis service, laboratories must participate in internal and external quality assurance activities, incorporate rigorous training protocols for technical staff and use reliable procedures. The World Health Organization laboratory manual for the examination of human semen and sperm cervical mucous interaction, clearly describes the variables that need to be assessed and the methods of analysis and quality assurance to be used.