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An age-based sperm nomogram: the McGill reference guide.

Mali Salmon-Divon1,2, Guy Shrem3,4, Jacques Balayla3

  • 1Department of Molecular Biology, Ariel University, Ariel, Israel.

Human Reproduction (Oxford, England)
|September 11, 2020
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Summary
This summary is machine-generated.

Age significantly impacts most semen parameters, with many showing a biphasic trend peaking in the fourth decade. This study provides age-specific nomograms to complement WHO guidelines, highlighting the importance of age in semen analysis.

Keywords:
WHO reference valuesagesemen analysissemen parameterssperm nomogram

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Area of Science:

  • Reproductive Medicine
  • Andrology
  • Biostatistics

Background:

  • Current World Health Organization (WHO) 2010 semen analysis reference limits do not account for male age.
  • A comprehensive, percentile-based nomogram illustrating age-related changes in semen parameters has been lacking for clinical use.
  • Understanding age-specific semen quality is crucial for accurate fertility assessments.

Purpose of the Study:

  • To develop age-dependent nomograms for key semen parameters.
  • To investigate the influence of male age on sperm concentration, motility, total count, morphology, and semen volume.
  • To provide a tool that complements existing WHO reference limits by incorporating age as a factor.

Main Methods:

  • Retrospective analysis of 12,188 semen samples from a fertility clinic (2009-2018).
  • Semen parameters analyzed using computer-assisted sperm analysis (CASA): concentration, motility, progressive motility, total count, morphology, and volume.
  • Age-dependent nomograms generated using regression quantiles (5th-95th percentiles) for individuals aged 20-60.

Main Results:

  • Age significantly influenced all parameters except morphology, showing a biphasic trend peaking in the fourth decade for the overall dataset.
  • In samples above WHO reference limits (ARL), age affected all parameters except concentration and morphology; only semen volume showed a biphasic trend.
  • Sperm motility, progressive motility, and total sperm count consistently declined with age in the ARL group.

Conclusions:

  • The study presents the first nomograms correlating age with semen quality across population percentiles, enhancing the WHO 2010 guidelines.
  • Most semen parameters exhibit non-linear changes with age, necessitating the routine inclusion of age in clinical semen analysis.
  • These age-specific nomograms can aid in more precise interpretation of semen quality in the context of male reproductive health.