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Semen analysis 

Semen analysis
Semen analysis

Franco Dondero

, Andrea Lenzi

, and Loredana Gandini

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date: 20 May 2022

Semen analysis remains the most important diagnostic tool for the study of male infertility to date. For this reason, and because of the ease of carrying out this analysis, examination of seminal fluid should be among the first diagnostic steps in cases of suspected infertility, prior to subjecting the man’s partner to long and complex diagnostic tests. The efficacy of an examination of seminal fluid depends on the experience and ability of the seminologist, who must first undertake a subjective analysis of fundamental parameters such as motility and morphology. Moreover, laboratories specialized in such analyses may apply different criteria to the evaluation of sperm parameters, making it extremely difficult to compare tests carried out in different laboratories (1).

In an attempt to resolve these problems of inconsistency, and in order to standardize laboratory techniques, a committee of experts from the WHO established guidelines for semen analysis in 1980 (an updated version was published in 1999) (2).

In recent years, numerous other methods of semen analysis capable of providing in-depth diagnostic information on the fertilising capacity of spermatozoa have become available. The computer-aided sperm analysis (CASA) system is a technique for sperm analysis designed to provide objective data on sperm motility (3). Because of persisting difficulties in software set-up (4), it should not be used for routine analysis, but rather as a research tool. At the same time, significant advances have been made in the study of sperm morphology through the use of scanning and transmission electron microscopes (5). Finally, within the past decade several tests capable of evaluating the integrity of sperm components, such as the membrane, acrosome, DNA, and nuclear protein, have been developed and put into use. These more complex and costly analytical tools should be considered of secondary or tertiary importance, and are to be carried out in specific cases only after standard semen analysis. Standard semen analysis remains the first and fundamental diagnostic tool.

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