Significance of sperm characteristics in the evaluation of male infertility
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Objective To compare sperm characteristics among: patients undergoing infertility evaluation, patients with male factor infertility (MFI), healthy sperm donors, and men with proven fertility; to examine the overlap of sperm characteristics in all four of these groups; and to identify good discriminators of fertility versus infertility among sperm characteristics. Design Retrospective study. Setting Male infertility clinic at a tertiary care hospital. Patient(s) Proven fertile men (n = 56), normal donors (n = 91), men presenting for infertility evaluation (n = 406), and MFI patients (n = 166). Intervention(s) None. Main outcome measure(s) Routine semen analysis. Result(s) Using current World Health Organization (WHO) reference values, a large group of MFI patients presented with higher sperm concentration (27.5 x 10(6) to 99.2 x 10(6)), resulting in broader overlap with fertile men and poor sensitivity (0.48). Similarly, percentage normal morphology (%) using Tygerberg's strict criteria was low in most of the MFI patients (sensitivity 0.83), almost half of the fertile men also presented with abnormal morphology (specificity 0.51). Of all the variables examined, sperm motility (%) was superior, having minimum overlap range (lower and upper cut-off values 46% and 75%) and high sensitivity (0.74) and specificity (0.90). Areas under curve were higher for motility (0.90) and concentration (0.84) compared with morphology (WHO 0.65 and Tygerberg's strict criteria 0.74). Conclusion(s) Sperm motility and concentration provide more accurate information than morphology (WHO and Tygerberg's criteria) during infertility evaluation. Redefining the reference values for concentration and morphology may significantly increase the importance of routine semen analysis.
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Standard semen parameters are poorly predictive for producing a pregnancy in vivo.
“Semen analysis is widely used as a surrogate measure of a man's reproductive capacity, but in truth, standard semen parameters are poorly predictive for producing a pregnancy in vivo (McLachlan et al., 2003;Li et al., 2006;Nallella et al., 2006).”
From Isolated abnormal strict morphology is not a contraindication for intrauterine insemination (2015) · cites this paper as Nallella et al., 2006
The introductory passage (indexed as Abstract; page unavailable) says a normal spermiogram does not necessarily indicate satisfactory fertility potential, and the Discussion reports substantial overlap in semen characteristics between fertile men and male-factor infertility patients. These findings support limits to standard semen parameters, but the paper evaluates discrimination between those groups rather than directly testing prediction of an in-vivo pregnancy. (LLM, conf=0.84)
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- Authors
- Nallella, K. P., Sharma, R. K., Aziz, N., & Agarwal, A.
- Affiliations
- Cleveland Clinic (US)
- Liverpool Women's Hospital (GB)
- Corresponding author
- Agarwal, Ashok
- Venue
- Fertility and Sterility
- Publisher
- Elsevier BV
- Published
- 2006-03
- Volume
- 85
- Issue
- 3
- Pages
- 629-634
- ISSN
- 0015-0282 (ISSN-L)
- OpenAlex
- W2150994798
- Cited by
- 288
- References
- 1
- Citations by year
- 2026: 3 · 2025: 7 · 2024: 15 · 2023: 11 · 2022: 18 · 2021: 11 · 2020: 12 · 2019: 15 · 2018: 25 · 2017: 21 · 2016: 14 · 2015: 15 · 2014: 25 · 2013: 17 · 2012: 12
- FWCI
- 14.82
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Fertility and Sterility (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Reproductive Medicine › Sperm and Testicular Function
- Health Sciences › Medicine › Reproductive Medicine › Reproductive Health and Technologies
- Health Sciences › Health Professions › General Health Professions › Male Reproductive Health Studies
- Keywords
- male infertility, sperm characteristics, semen analysis, sperm motility, sperm concentration, sperm morphology, WHO reference values, fertility assessment, sensitivity and specificity
- MeSH terms
- Humans, Infertility, Male, Male, Sensitivity and Specificity, Sperm Count, Sperm Motility, Spermatozoa, Case-Control Studies
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