Evaluation of reference values of standard semen parameters in fertile Egyptian men

Abstract

SummaryThe reference values of human semen, published in the WHO's latest edition in 2010, were lower than those previously reported. The objective of this study was to evaluate reference values of standard semen parameters in fertile Egyptian men. This cross-sectional study included 240 fertile men. Men were considered fertile when their wives had recent spontaneous pregnancies with time to pregnancy (TTP) ≤12 months. The mean age of fertile men was 33.8 ± 0.5 years (range 20-55 years). The 5th percentiles (95% confidence interval) of macroscopic semen parameters were 1.5 ml for volume and 7.2 for pH. The 5th percentiles of microscopic parameters were 15 million/ml for sperm concentration, 30 million per ejaculate for total sperm count, 50% for total motility, 40% for progressive motility, 62% for vitality, 4% for normal sperm forms and 0.1 million/ml for seminal leucocyte counts. In conclusion, fertile Egyptian men had higher reference values of sperm total motility, progressive motility and vitality, and lower reference values for total sperm counts as compared to those determined by the latest edition of the WHO laboratory manual in 2010. Other semen parameters were identical to those defined by the WHO 2010 manual. | IntroductionStandard procedures of semen analysis are routinely used in most laboratories for initial evaluation of male fertility potential. These procedures include initial macroscopic examination of semen appearance, liquefaction, volume, viscosity and pH; and microscopic investigation of sperm concentration, motility and morphology; and assessment of seminal leucocytes and immature germ cells (WHO, 2010). Despite its weaknesses as a diagnostic tool, standard semen analysis allows for detection of remarkable cases of infertility such as azoospermia (Saleh et al., 2002). In addition, with repetitively abnormal semen analyses results, men can be diagnosed as infertile and an approximate prognosis can be given.The methods of human semen evaluation are provided by the WHO, which periodically releases manuals including specific protocols and reference standards (Esteves, 2014). The WHO published its updated 5th edition of the laboratory manual for the examination of human semen in late 2010. This latest edition of the manual established reference values derived from data belonging to eight countries located in three continents from 1953 fertile men with a time to pregnancy (TTP) of <1 year (Cooper et al., 2010). The new reference values

Home sperm testing device versus laboratory sperm quality analyzer: comparison of motile sperm concentration

“…The simulation of MSC was performed by independently generating more than 100,000 MSC values, based on the WHO published distributions for concentration and percentage of total motility (data not shown). The calculated cutoff was further supported with other publications that sought to determine values for semen measurements that best discriminate between fertile and infertile men by using the same 5th percentile approach (27)(28)(29).…”

Distribution of semen examination results 2020 – A follow up of data collated for the WHO semen analysis manual 2010

“…Since 2010, seven published studies have been identified as potentially suitable for detailed assessment. Data was kindly supplied from five published studies 4–8 (Table 1). Five studies documented using WHO standards for assessment (WHO 2010) however the morphology assessment by Aboutorabi et al 5 was not compliant with WHO 2010 and therefore has been excluded.…”

“…Five studies documented using WHO standards for assessment (WHO 2010) however the morphology assessment by Aboutorabi et al 5 was not compliant with WHO 2010 and therefore has been excluded. Vitality assessments were only available from the study by Evgeni et al 8 Lotti et al 4 , Tang et al 7 and Zedan et al 6 After accounting for an abstinence period of 2–7 days and a TTP of ≤12 months, up to 1789 subjects were analysed (Analysis 1: 2010–2020). Not all information was available for each subject.…”

The future of sperm: a biovariability framework for understanding global sperm count trends

“…Of note, the 2010 WHO reference values for semen parameters do not predict infertility, as the values were determined by studying fertile men; therefore, while the top 95% of sperm concentrations in the sample were taken to be the reference range, all of the men with sperm concentrations below the 5th centile were also fertile (Chiles & Schiegel, 2015;Cooper et al, 2010). Other studies from across the world have similarly confirmed the fertility of men below the WHO reference values (Haugen et al, 2006;Tang et al, 2015;Zedan et al, 2018).…”