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Volume 14, Issue 1 (January 2012) 14, 6–13; 10.1038/aja.2011.58

Semen analysis and sperm function testing

Daniel R Franken1 and Sergio Oehninger2

1 Department of Obstetrics and Gynaecology, Tygerberg Hospita, Tygerberg, Cape Town 7505, South Africa
2 Department of Obstetrics and Gynaecology, Eastern Virginia Medical School, Jones Institute for Reproductive Medicine, Norfolk, VA 23507, USA

Correspondence: Professor DR Franken, (drf@sun.ac.za)

Received 25 May 2011; Revised 26 August 2011; Accepted 17 November 2011; Published online 19 December 2011.


Despite controversy regarding the clinical value of semen analysis, male fertility investigation still relies on a standardized analysis of the semen parameters. This is especially true for infertility clinics in both developing and developed countries. Other optional tests or sophisticated technologies have not been widely applied. The current review addresses important changes in the analysis of semen as described in the new World Health Organization (WHO) manual for semen analysis. The most important change in the manual is the use of evidence-based publications as references to determine cutoff values for normality. Apart from the above mentioned changes, the initial evaluation and handling methods remain, in most instances, the same as in previous editions. Furthermore, the review evaluates the importance of quality control in andrology with emphasis on the evaluation of sperm morphology. WHO sperm morphology training programmes for Sub-Saharan countries were initiated at Tygerberg Hospital in 1995. The external quality control programme has ensured that the majority of participants have maintained their morphological reading skills acquired during initial training. This review reports on current sperm functional tests, such as the induced acrosome reaction, and sperm-zona pellucida binding assays, as well as the impact of sperm quality in terms of DNA integrity, and the relationship of sperm function tests to sperm morphology.

Keywords: male infertility; quality assurance; semen analysis; spermatozoa; sperm concentration; sperm function; sperm morphology; sperm motility

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