The Semen Analysis Guideline Has Been Updated

Semen analysis is the first test that should be evaluated in couples who cannot have children and provides the most useful information about sperm production. At the Irenbe IVF Center, semen analysis plays a guiding role in the patient’s treatment. According to the results of the semen analysis, decisions are made regarding IUI (intrauterine insemination) or IVF treatment for the infertile couple. In addition, when necessary, it is used as the first step in directing patients to sperm freezing or TESA/TESE (sperm retrieval from the testicles).

Semen analysis can be useful not only in investigating male fertility status, but also in monitoring spermatogenesis during and after treatment, both in clinical and research settings.

When evaluating sperm analysis, reports are prepared according to the World Health Organization (WHO) Laboratory Manual.

The World Health Organization (WHO) most recently updated its guideline for the examination of human semen and sperm in late 2021 as the 6th edition, following the previous update in 2010.

The first WHO laboratory manual, “WHO Laboratory Manual for the Examination of Human Semen and Sperm–Cervical Mucus Interaction,” was published in 1980 in response to the need for standardization of semen analyses. Since then, the manual has been updated four times and translated into many languages. Over the last 40 years, it has become the global standard used widely by research and clinical laboratories.

The methods included in this update aim to improve the quality of semen analysis and the comparability of results.

When determining reference ranges and limits, semen quality from fertile men whose partners conceived within 12 months after discontinuing contraception was used as the basis. Raw data from recently fertile fathers from different continents and countries were included.

Some considerations regarding reference ranges:

• Because semen characteristics vary greatly both within the same individual and between different men, semen analysis alone cannot determine a couple’s fertility status.
• Semen parameters that fall within the 95% reference range do not guarantee fertility.
• By definition, 5% of fertile men have semen parameters below these reference limits.
• Men whose semen characteristics are below these limits are not necessarily infertile.
• Semen parameters should always be evaluated together with clinical information.

Differences between WHO 2010 and WHO 2021 normal sperm parameters:

Due to the time differences in updating laboratory software and protocols, sperm analysis reports with different reference values may be encountered for a short period. As the Irenbe IVF Center, we have updated the reference values in our sperm analysis reports according to the WHO 2021 criteria.