Semen Analysis in the 21st Century

06Feb, 2023

Semen Analysis in the 21st Century

Semen analysis serves as the foundation for the laboratory assessment of the infertile male and aids in determining the degree of the male factor. About 15% of the couples are unable to conceive after a year of unprotected intercourse. A male factor is solely responsible in about 20% of infertile couples and contributory in another 30-40%. Although, the semen analysis is not a test of fertility, it can be regarded as an important single indicator of the functional status in the male reproductive tract.

The Evolution

The function of a man’s semen in human reproduction has been the subject of theories since antiquity. Semen analysis procedures are thought to have originated in the 20th century. The earliest techniques for semen analysis were reportedly used in the early 20th century. However, spermatozoa were first observed in ejaculates in the 17th century, marking the beginning of the history of reproductive medicine.

edward martin

Did you Know???

Edward Martin (1859 – 1938), was the first person to suggest that semen analysis should be a routine investigation in the evaluation of every case of Infertility.

The first surgeon to successfully cure obstructive azoospermia was Edward Martin, who described this achievement in 1902. He then performed a total of 11 similar procedures, which led to seven successes and three pregnancies. He was likely the first clinician to demonstrate congenital absence of vas , vasal atrophy, and surgically correcting obstruction of the ejaculatory duct. Most importantly, he provided evidence that treating male infertility requires an accurate diagnosis. He was also the first to recognize the polymorphism of human sperm.

Semen analysis was later turned from mere observation to a science by John McLeod. He understood that assessing the potential fertility of semen required consideration of sperm motility and morphology in addition to sperm numbers. He even made an effort to link particular sperm morphologies to particular clinical entities, like varicocele.

Semen analysis is a tool to help determine fertility; it is not a definitive indicator of a person's fertility. The interaction between the male sperms and the female egg is crucial to the outcome in terms of pregnancy, and this cannot be predicted even if the semen analysis is normal.

What does the test result mean to an individual?

There are several purposes that a diagnostic test can serve. Informing the patient of his normal or abnormal status is the first step. In addition, a test can offer a diagnosis. The provision of a prognosis is a third role.

Semen analysis can diagnose of abnormalities of number, appearance, movement of sperms. It is possible to suspect pathology on examination of semen.

What to anticipate and how is it beneficial?

  • • Semen ejaculate volume
  • • Sperm concentration
  • • Total sperm count
  • • Total and progressive motility
  • • Vitality
  • • Sperm morphology
  • • pH, leucocytes, and fructose

Semen analysis has a number of benefits, including being a simple and inexpensive process. It is non-invasive and used as a first line of diagnostics to determine the root of a variety of ailments. As there is a WHO criteria, a regular and standardized approach to semen analysis allows comparison between laboratories.

Operator dependency may appear to be a drawback in view of inter-observer variation. Computer Assisted Semen Analysis (CASA) often overcomes this though manual examination also has its own merits. The laboratory environment and handling of semen sample has an impact on the test results. Hence a good Laboratory with robust quality control is important.

What are we trying to achieve?

An infertile couple should have their underlying condition identified so that it can be treated, and the proper tests should be ordered to fully comprehend the issue so that the best course of action can be recommended.

Semen analysis is only partially accurate as a predictor of fertility, according to research from the World Health Organization, because of ambiguous parameter thresholds, the exclusion of female fertility determinants, and the potential for internal fluctuation in semen parameters. The success rate of IVF or ICSI applicable to your specific situation cannot be correctly predicted by your doctor using a semen analysis test alone.

The results of such testing may allow for the use of more cost-efficient treatment or even provide the basis for a couple to cease treatment. The sperm function testing, as well as other genetic and andrology tests are the sequels suggested for an abnormal semenogram, in managing infertility.

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