Significance of sperm characteristics in the evaluation of male infertility

Center for Advanced Research in Human Reproduction, Infertility and Sexual Function, Glickman Urological Institute, Department of Obstetrics-Gynecology, Cleveland Clinic Foundation, Cleveland, Ohio 44195, USA.
Fertility and sterility (Impact Factor: 4.59). 04/2006; 85(3):629-34. DOI: 10.1016/j.fertnstert.2005.08.024
Source: PubMed


To compare sperm characteristics among: patients undergoing infertility evaluation, patients with male factor infertility (MFI), healthy sperm donors, and men with proven fertility; to examine the overlap of sperm characteristics in all four of these groups; and to identify good discriminators of fertility versus infertility among sperm characteristics.
Retrospective study.
Male infertility clinic at a tertiary care hospital.
Proven fertile men (n = 56), normal donors (n = 91), men presenting for infertility evaluation (n = 406), and MFI patients (n = 166).
Routine semen analysis.
Using current World Health Organization (WHO) reference values, a large group of MFI patients presented with higher sperm concentration (27.5 x 10(6) to 99.2 x 10(6)), resulting in broader overlap with fertile men and poor sensitivity (0.48). Similarly, percentage normal morphology (%) using Tygerberg's strict criteria was low in most of the MFI patients (sensitivity 0.83), almost half of the fertile men also presented with abnormal morphology (specificity 0.51). Of all the variables examined, sperm motility (%) was superior, having minimum overlap range (lower and upper cut-off values 46% and 75%) and high sensitivity (0.74) and specificity (0.90). Areas under curve were higher for motility (0.90) and concentration (0.84) compared with morphology (WHO 0.65 and Tygerberg's strict criteria 0.74).
Sperm motility and concentration provide more accurate information than morphology (WHO and Tygerberg's criteria) during infertility evaluation. Redefining the reference values for concentration and morphology may significantly increase the importance of routine semen analysis.

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    • "Morphology of the spermatozoa is the end result of a highly complex process of cellular modifications occurring during the process of spermiogenesis (Rowe et al., 1993; WHO, 1999). Spermatozoal morphology is considered as the best predictor of fertility by some clinicians (Menkveld et al., 2001; Nallella et al., 2006). It has always been an important part of semen analysis to evaluate the percentage of morphologically normal spermatozoa as well as the determination of various morphological defects (Rowe et al., 1993; WHO, 1999). "
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    ABSTRACT: The aim of the study was to assess the semen quality and levels of spermatozoal nuclear DNA fragmentation in subfertile subjects clinically diagnosed with varicocele, subfertile subjects without varicocele and healthy fertile controls. Semen samples were obtained from 302 subjects. Of them, 115 were healthy fertile controls having normal semen characteristics, 121 subfertile men diagnosed with varicocele, both, clinically and on ultrasonography, while 66 subjects were subfertile with no varicocele. Spermatozoal concentration, percentage motility, morphology and DNA fragmentation were measured. In the study population, deterioration in semen quality-decreased spermatozoal concentration, percentage motility and normal morphology was seen in subfertile subjects, especially with varicocele. Highest spermatozoal DNA fragmentation was observed in varicocele-positive subjects as compared with varicocele-negative subjects and healthy fertile controls. Significant negative correlation was seen between spermatozoal DNA fragmentation and concentration (r = −0.310), motility (r = −0.328) normal morphology, WHO method (r = −0.221) and Tygerberg strict criteria (r = −0.180) in the varicocele-positive subfertile subjects. In conclusion, this study suggests existence of a negative relationship between spermatozoal DNA fragmentation and semen quality in varicocele-positive subfertile subjects.
    Andrologia 10/2014; 47(8). DOI:10.1111/and.12360 · 1.63 Impact Factor
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    • "Infertility is the inability to contribute conception after 12 months of unprotected intercourse; this may be due to male, female or some unexplained factors. Males alone contribute 35% to 40 % of infertile cases [1] [2] . "
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    ABSTRACT: Objective To elucidate the effect of age and sexual abstinence on semen quality (semen volume, total count, progressive motility, vitality and morphology). Methods A total of 730 semen samples were analyzed. Subjects were grouped according to the age (20-29, 30–34, 35–39 and 40–50) and abstinence (2–3, 4–5 and 6–7). Semen parameters were evaluated following WHO standard criteria. Results Analysis of 730 semen samples showed negative correlation of progressive motility (r=-0.131, P< 0.01), vitality (r=-0.173, P< 0.01), morphology (r=-0.324, P< 0.01) with age. With increase in age percentage of progressive motility, vitality and normal morphology in mean values declined after the age group of 35–39 to 40–50 years, but no change in volume and count were observed. Increase in abstinence with individual days significantly affected semen volume (H= 20.65, P< 0.001), count (H= 36.67, P<0.01), progressive motility (H= 13.53, P<0.05) and vitality (H= 15.33, P< 0.01). But, no effect was found on sperm morphology. Mann Whitney U test confirmed the changes in semen volume, total count and vitality in paired grouping from 2–7 days (P<0.05), but changes in sperm motility were observed after 5 days of abstinence in each paired group upto 7 days (P<0.05). Mean values of semen parameters among three abstinence groups (2–3, 4–5 and 6–7 days) also showed similar result. Conclusions In the present study, age negatively affected progressive motility, vitality and morphology of human sperm. Semen samples showed intra varied results within WHO amended abstinence period.
    06/2014; 3(2):134-141.. DOI:10.1016/S2305-0500(14)60017-8
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    • "Increasing incidence of infertility has been a global health as well as a social problem, where 35-40% of male partners are solely responsible.[1] Apart from the well-known conventional causes, i.e., disturbance in the endocrine system, anatomy, genetic makeup, varicocele or torsion, occurrence of diabetes and subtle unknown infections, chronic exposure to toxic chemicals and differential unhygienic lifestyle patterns too contribute to male infertility.[2] Tobacco consumption is one of the lifestyle factors that is often detrimental to human health as a whole.[3] "
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    ABSTRACT: AIM:The aim of the following study is to find out the prevalence of abnormal spermatozoa and associated functional parameters in clinical semen samples of sub-fertile males with the tobacco chewing habit.SETTINGS AND DESIGN:Retrospective study was conducted at infertility unit of a tertiary health care center, in a period of 3 years.MATERIALS AND METHOD:Semen of 642 males were analyzed; of them 194 men (30.2%) were tobacco chewers and they were grouped according to their intensity of chewing (<10 and ≥ 10 packets/day). Counts, motility, vitality, and morphology of sperms were analyzed.RESULTS:In tobacco chewers, 66% of subjects were oligozoospermic, 85% asthenozoospermic and 28% teratozoospermic. Sperm counts (odds ratio [OR] =2.2; 95% confidence interval [CI]: 1.5-3.09), motility (OR = 3.2; 95% CI: 2.05-4.9), and normal morphology (OR = 8.4; 95% CI: 4.9-14.6) were significantly affected (P = 0.001) in tobacco chewers than the non-chewing group. Further, in comparison to the intensity of tobacco chewing, patients with the intensive practice of using ≥10 packets/day had a significant effect on sperm morphology (P = 0.003, OR = 2.7; 95% CI = 1.41-5.08) only. Structural defects in head (P = 0.001) and cytoplasmic residues (P = 0.001) were found to be positively correlated with the intensive chewing, but no significant changes were found in anomalies in mid-piece and tail.CONCLUSION:The adverse impact of tobacco chewing on semen parameters was evident even with mild chewers, but with the intensive chewing practice, phenotypes of sperms, mainly defects in the head and cytoplasmic residue were severely affected.
    Journal of Human Reproductive Sciences 04/2014; 7(2):136-42. DOI:10.4103/0974-1208.138873
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