Computer-assisted semen analysis parameters as predictors for fertility of men from the general population

Abstract

The predictive value of sperm motility parameters obtained by computer-assisted semen analysis (CASA) was evaluated for the fertility of men from general population. In a prospective study with couples stopping use of contraception in order to try to conceive, CASA was performed on semen samples from 358 men. A recently developed CASA system, Copenhagen Rigshospitalet Image house sperm Motility Analysis System (CRISMAS) was used for assessment of motility parameters. This system has an editing function which allows correction of tracks made by the computer. Probably due to this function, the concentration assessment made by CRISMAS was very close to that made by the technician (median difference <5%) in all concentration ranges. Correlation between CASA parameters and fertility of normal couples (measured as probability of achieving pregnancy) was examined by the Cox regression model. In univariate models ln(sperm concentration) [beta = 0.331, risk ratio (RR) = 1.392, P = 0.0001], ln(total sperm count) (beta = 0.252, RR = 1.286, P = 0.0007) and percentage motile spermatozoa (beta = 0.014, RR = 1.014, P = 0.0004) were most significant predictors for fertility. In a multivariate analysis ln(sperm concentration) (beta = 0.268, RR = 1.307, P = 0.0016) and percentage motile spermatozoa (beta = 0.010, RR = 1.010, P = 0.011) but even more significantly the combined parameter, ln(concentration of motile spermatozoa) (beta = 0.329, RR = 1.389, P = 0.0001), were the only parameters of predictive value for fertility of men in the general population. In conclusion, these parameters obtained by CASA measurements can be used for prediction of fertility potential in normal men. This appears to be the first study showing the value of CASA in prediction of fertility in the general male population.

Counting sperm does not add up any more: time for a new equation?

“…In our laboratories, we have concentrated on developing a test (Fertell; Bjorndahl et al 2006) based on assessing the concentration of progressively motile sperm, which is one of the most predictive parameters for estimating natural fertility in both sub-fertile (review Tomlinson et al 1999) and normal couples (Larsen et al 2000, Zinaman et al 2000; Fig. 1).…”

Cigarette smoking and alcohol consumption are enemy of male fertility? A patho-radiological correlation study

“…14,17,18 Sperm motility is well known to be a good predictor of male fertility in vivo and in vitro also and this thing has also been found strongly associated with probability of conception. [19][20][21] Choline acetyl transferase (CAT) is known to facilitate sperm motility and cigarette smoke condensates have CAT inhibitors which lead to reduced sperm motility. 22 Strong relationship has been observed between sperm motility and number of cigarettes smoked per day in a study of Zhang, et al 23 Reduced sperm motility was also found by other researchers in smokers.…”

Quality assurance and quality control in the laboratory andrology

“…The four-grade system was underpinned by observations that only sperm with specific motility patterns were able to penetrate the cervical mucus (and therefore enter the female reproductive tract) [20,21]. The advantage of measuring sperm motility in this way has been further supported by the use of computer-assisted sperm analysis (CASA), which has positively correlated the concentration of sperm swimming at > 25 μm per second with the probability of conception [22].…”

“…This view is also shared by delegates attending training courses in the UK organized by the Association of Biomedical Andrologists (http:// www.aba.uk.net), who reported that the assessment of sperm as grade a or b was the most problematic of the practical techniques in semen analysis (personal observation). Perhaps this is unsurprising given that a human observer is being asked to replicate by eye the measurements first made using high-speed cinematographic analysis [20,21] or commercially available CASA systems [22].…”