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Asian Journal of Andrology (2010) 12: 64-70. doi: 10.1038/aja.2009.4
Semen analysis in 21st century medicine: the need for sperm function testing
Dolores J. Lamb1
1 Scott Department of Urology and the Department of Molecular and Cellular Biology, Baylor College of Medicine, Houston, TX 77030, USA
Correspondence: Dr Dolores J. Lamb, Scott Department of Urology and the Department of Molecular and Cellular Biology, Baylor College of Medicine, One Baylor Plaza RM N730, Houston, TX 77030, USA. Fax: +1-713-798-5577 E-mail: dlamb@bcm.tmc.edu
Received 6 November 2008; Revised 10 November 2008; Accepted 4 January 2009.
| Abstract |
Sperm function testing, once commonly performed for the infertile couple before employing assisted reproductive technology (ART), has fallen out of favour in many reproductive medicine centers throughout the world. Indeed, the most recent addition of the 'World Health Organisation (WHO) Laboratory Manual for the Examination and Processing of Human Semen' now groups many of these procedures into a section termed Research Procedures. In large part, this reflects the current clinical practice of bypassing the in-depth evaluation of the male partner, while assuming that if a spermatozoon can be found for intracytoplasmic sperm injection (ICSI), it must be a healthy cell capable of achieving fertilization. Nevertheless, sperm function testing can provide valuable clinical insights into defects causing male infertility. Admittedly, in some cases, functional sperm deficiencies can be overcome using an ART. In other cases, couples will be empowered by the knowledge of the cause of their infertility, and for some couples, perhaps even the likelihood of ICSI success (relative to the spermatozoa). The knowledge allows them to make truly informed reproductive decisions, including (perhaps) the decision to seek donor insemination, to adopt or to remain childless. Knowledge of the cause of their infertility may provide closure for couples and a sense of confidence regarding their choice of reproductive treatment.
Keywords: semen analysis, sperm function tests |
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