Semen analysis in 21st century medicine: the need for sperm function testing.

Area of Science:

• Reproductive Medicine
• Andrology
• Infertility Diagnostics

Background:

• Sperm function testing, historically crucial for infertile couples, is declining in clinical practice.
• Current trends often bypass detailed male partner evaluation, assuming sperm suitable for intracytoplasmic sperm injection (ICSI) are healthy.
• The World Health Organisation (WHO) now categorizes many sperm function tests under 'Research Procedures'.

Purpose of the Study:

• To highlight the continued clinical value of sperm function testing in diagnosing male infertility.
• To emphasize how functional sperm analysis can inform assisted reproductive technology (ART) choices.
• To underscore the importance of this knowledge for couples' reproductive decision-making.

Main Methods:

• Review of current clinical practices in reproductive medicine centers.
• Analysis of the World Health Organisation (WHO) Laboratory Manual for semen examination.
• Discussion of the implications of sperm function testing for infertile couples.

Main Results:

• Sperm function testing provides crucial insights into male infertility defects.
• Functional deficiencies, while sometimes manageable with ART, impact fertilization potential.
• Knowledge of sperm function empowers couples with information for informed reproductive choices.

Conclusions:

• Despite declining use, sperm function testing remains a valuable tool in male infertility assessment.
• Understanding sperm health can guide treatment decisions, including the likelihood of ICSI success.
• Informed couples can make confident choices regarding fertility treatments, donor insemination, adoption, or remaining childless.