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Abstract

Volume 12, Issue 1 (January 2010) 12, 59–63; 10.1038/aja.2008.57

Comments on the release of the 5th edition of the WHO Laboratory Manual for the Examination and Processing of Human Semen

W. C. L. Ford

Obstetrics & Gynaecology Unit, Clinical Science at South Bristol, University of Bristol, St Michael's Hospital, Bristol BS2 8EG, UK

Correspondence: Dr W. C. L. Ford, E-mail: chris.ford@bristol.ac.uk

Received 3 December 2008; Revised 5 December 2008; Accepted 12 December 2008

Abstract

The authors of the World Health Organization Semen Analysis Manual are to be congratulated on producing a new edition; it is an essential tool to disseminate good practice in andrology. However, the tests described have poor prognostic power to predict a man's fertility and show little about the underlying causes of sub-fertility. This commentary urges a revival of research into the diagnosis of male fertility. It suggests that fertility should be regarded as a continuum and that the artificial binary division between fertile and infertile should be abandoned. Models to predict a sub-fertile couple's chance of conception in a year should be developed on the basis of prospective data. These models would allow for sophisticated decision making about management. The future lies in the identification of tests to detect underlying pathologies open to specific treatment. Leads such as oxidative stress, defects in the intracellular regulation and the developing field of proteomics should be explored.

Keywords: diagnosis, male infertility, oxidative stress, predictive value of tests, sperm count

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