Clinical relevance of routine semen analysis and controversies surrounding the 2010 World Health Organization criteria for semen examination
Int. braz. j. urol
;
40(4): 433-453, Jul-Aug/2014. tab, graf
Artigo
em Inglês
| LILACS
| ID: lil-723960
ABSTRACT
Semen analysis is the corner stone of infertility evaluation as it provides information on the functional status of the seminiferous tubules, epididymis and accessory sex glands. The methods on how the human semen should be evaluated are provided by the World Health Organization, which periodically releases manuals that include specific protocols and reference standards. In 2010, the WHO published new criteria for human semen characteristics that were markedly lower than those previously reported. In this review initially it is discussed the limitations of semen analysis as a surrogate measure of a man’s ability to father a pregnancy. Secondly, it is analyzed methodology issues that could explain why the newly released reference values were different from those earlier reported. Thirdly, it is speculated on the likely effects of the 2010 WHO criteria in the management of male infertility. Due to the several inherent limitations of semen analysis as a surrogate marker of male infertility, physicians should exercise caution when interpreting results. A template for semen analysis reports that incorporates the distribution of the semen characteristics of recent fathers in centiles rather than solely the minimum thresholds could aid clinicians to better understand how a given patient results compare with the reference population. Importantly, a male infertility evaluation must go far beyond a simple semen analysis, as it has to be complemented with a proper physical examination, a comprehensive history taking, and relevant endocrine, genetic, and other investigations.
Texto completo:
DisponíveL
Índice:
LILACS (Américas)
Assunto principal:
Guias como Assunto
/
Análise do Sêmen
Tipo de estudo:
Estudo diagnóstico
/
Guia de Prática Clínica
/
Revisões Sistemáticas Avaliadas
Limite:
Humanos
/
Masculino
Idioma:
Inglês
Revista:
Int. braz. j. urol
Assunto da revista:
Urologia
Ano de publicação:
2014
Tipo de documento:
Artigo
País de afiliação:
Brasil
Instituição/País de afiliação:
Andrology & Human Reproduction Clinic/BR
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