[Which technique is best for which male infertility?]

Area of Science:

• Reproductive Medicine
• Andrology
• Semen Analysis

Context:

• Current semen analysis guidelines by the World Health Organization (WHO) may lack sufficient predictive power for fertility outcomes.
• Established normality benchmarks for semen parameters are debated, necessitating a review of existing criteria.
• The role of sperm chromatin and DNA integrity in predicting successful fertilization and pregnancy requires further investigation.

Purpose:

• To evaluate the validity and reliability of current sperm analysis parameters.
• To explore the necessity of reassessing established normal values for semen parameters.
• To investigate the utility of additional criteria, such as DNA fragmentation, in predicting fertility outcomes.

Summary:

• Literature review indicates that World Health Organization (WHO) normal values for semen parameters might need reassessment.
• Sperm DNA fragmentation, a key indicator of sperm health, is not universally adopted by organizations like the American Society for Reproductive Medicine (ASRM) for predicting pregnancy rates.
• Threshold values for semen parameters in assisted reproductive technologies like intrauterine insemination (IUI) and intracytoplasmic sperm injection (ICSI) show variability and controversy, with a lack of robust prospective studies.

Impact:

• Highlights the need for updated guidelines in semen analysis to improve diagnostic accuracy.
• Emphasizes the importance of incorporating sperm DNA integrity testing into routine fertility assessments.
• Suggests a direction for future research focusing on high-quality, multivariate studies to establish reliable predictive thresholds for assisted reproduction.