Management of male factor infertility: position statement from the Italian Society of Andrology and Sexual Medicine (SIAMS)

Inflammation and Oxidative Stress in Seminal Plasma: Search for Biomarkers in Diagnostic Approach to Male Infertility

“…In conclusion, despite several studies on antioxidants and seminal fluid parameters, some new aspects should be clarified to better adapt trials on pathophysiological evidence, since most studies in this field are considered of low quality [ 50 ]. In the present study, a peculiar FLC pattern in varicocele patients’ seminal plasma has been detected.…”

Clinical Interpretation of Semen Analysis

“…The presence of ASA as an isolated abnormality is seen in less than 5% of infertile males and occurs mainly in association with normal sperm counts [8]. In fact, testing for ASA can be requested in case of unexplained couple infertility with normozoospermic male partner [9]. ASA can interfere with physiological reproduction at many levels, affecting sperm number and motility, the ability to transit through cervical mucus, acrosome reaction, and zona pellucida binding [9,10].…”

“…Reduced semen volume with normal pH, instead, can be seen in case of severe hypoandrogenism (scenario C). When semen volume and pH are normal, the analysis of the pellet smears for the presence of spermatogenetic cells is useful [9]. If they are present, a maturation arrest can be suspected (scenario D), while if they are absent, a proximal obstruction can be the cause (scenario E).…”

“…For this reason, the new WHO manual also describes a series of test which are part of the so-called extended examinations. Among them, the evaluation of sperm DNA fragmentation is already introduced in many laboratories all over the world; however, its clinical utility remains still controversial [1,9]. Another section of the WHO manual deals with advanced functional tests which are aimed at assessing the competence of human spermatozoa to fulfil those processes which are essential to conception.…”

Comment on Boitrelle et al. The Sixth Edition of the WHO Manual for Human Semen Analysis: A Critical Review and SWOT Analysis. Life 2021, 11, 1368

“…It is also useful to remind that the other meaningful modification of the Sixth Edition is the strong rejection of the equation “5th percentile = Threshold”. It is well known that the overlap between fertile and infertile subjects increases as the total sperm number worsens [ 4 , 5 ]. Reference ranges and thresholds are useless if they are not inserted in the clinical context of the infertile couple.…”