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Interpretation of semen analysis using WHO 1999 and WHO 2010 reference values: Abnormal becoming normal.

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The 2010 World Health Organization (WHO) semen analysis criteria reclassified many men from abnormal to normal. This shift impacts male fertility assessments and requires careful consideration in clinical practice.

Keywords:
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Area of Science:

  • Andrology
  • Reproductive Medicine
  • Clinical Laboratory Science

Background:

  • Semen analysis interpretation evolved with updated World Health Organization (WHO) guidelines.
  • The 2010 WHO manual introduced lower reference values compared to the 1999 guidelines.

Purpose of the Study:

  • To evaluate the impact of the WHO 2010 semen analysis criteria on male fertility classifications.
  • To compare semen analysis results using both WHO 1999 and WHO 2010 criteria in a Middle Eastern and Pakistani population.

Main Methods:

  • Retrospective review of semen analyses from 661 men.
  • Classification of semen parameters according to WHO 1999 and WHO 2010 criteria.
  • Analysis of classification changes from abnormal to normal based on the updated criteria.

Main Results:

  • Using WHO 2010 criteria, 19% of men shifted from abnormal to normal classification when considering all parameters.
  • When at least one abnormal parameter was present, 44% of men reclassified from abnormal to normal under WHO 2010 guidelines.
  • A significant proportion of men previously diagnosed with abnormal semen analysis are now considered normal under the newer criteria.

Conclusions:

  • The WHO 2010 criteria lead to a substantial increase in normal semen analysis classifications.
  • Clinical management and interpretation strategies need to address discrepancies between WHO 1999 and WHO 2010 cut-offs.
  • Further discussion is warranted for patients falling between the WHO 1999 and WHO 2010 reference values.