PD29-05 WHICH INFERTILE MEN WITH NORMAL SEMEN ANALYSIS DESERVE A SECOND SEMEN ANALYSIS IN THE REAL-LIFE SETTING?

Abstract

You have accessJournal of UrologyInfertility: Epidemiology & Evaluation II (PD29)1 Sep 2021PD29-05 WHICH INFERTILE MEN WITH NORMAL SEMEN ANALYSIS DESERVE A SECOND SEMEN ANALYSIS IN THE REAL-LIFE SETTING? Luca Boeri, Paolo Capogrosso, Edoardo Pozzi, Luigi Candela, Federico Belladelli, Walter Cazzaniga, Giuseppe Fallara, Daniele Cignoli, Nicolò Schifano, Eugenio Ventimiglia, Gianmarco Colandrea, Massimo Alfano, Costantino Abbate, Francesco Montorsi, and Andrea Salonia Luca BoeriLuca Boeri More articles by this author , Paolo CapogrossoPaolo Capogrosso More articles by this author , Edoardo PozziEdoardo Pozzi More articles by this author , Luigi CandelaLuigi Candela More articles by this author , Federico BelladelliFederico Belladelli More articles by this author , Walter CazzanigaWalter Cazzaniga More articles by this author , Giuseppe FallaraGiuseppe Fallara More articles by this author , Daniele CignoliDaniele Cignoli More articles by this author , Nicolò SchifanoNicolò Schifano More articles by this author , Eugenio VentimigliaEugenio Ventimiglia More articles by this author , Gianmarco ColandreaGianmarco Colandrea More articles by this author , Massimo AlfanoMassimo Alfano More articles by this author , Costantino AbbateCostantino Abbate More articles by this author , Francesco MontorsiFrancesco Montorsi More articles by this author , and Andrea SaloniaAndrea Salonia More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002030.05AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Current EAU Guidelines suggest that during the diagnostic work-up of an infertile man one semen analysis is sufficient in the case of normality as for WHO criteria. Conversely, a second test is recommended when the first one is abnormal. We aimed to investigate the rate and the clinical characteristics of infertile men with abnormal sperm parameters at a second test, after a normal first semen analysis. METHODS: Complete demographic, clinical and laboratory data from 1358 consecutive primary infertile men (defined according to the WHO definition) were considered. Comorbidities were scored with the Charlson Comorbidity Index (CCI). Serum hormones were measured in every patient. Patients underwent two consecutive semen analyses at the same laboratory (following 2010 WHO reference criteria). Descriptive statistics and logistic regression models tested the association between clinical variables and semen parameters. ROC curves were used to create a composite risk score for pathological sperm parameters at a second test. RESULTS: At first analysis, 212 (15.6%) infertile men had normal semen parameters. Of 212, 87 (41.0%) had a second normal semen analysis, while 80 (37.7%), 35 (16.5%) and 10 (4.7%) men showed 1, 2 and 3 pathological parameters at a second test. Men with a pathological second semen analysis had higher CCI, smaller testicular volume and higher FSH values (all p<0.01) than those with normal second test. Sperm concentration was also lower, 34 (23-57) vs. 62 (35-94) (p<0.01). At multivariable logistic regression analysis, smaller testicular volume (OR 0.9, p=0.03), FSH (OR 1.2, p<0.01), and lower sperm concentration (OR 0.9, p<0.01) were associated with pathological second semen analyses, after accounting for age and CCI. ROC curves showed that testicular volume <15 ml, FSH values >6 mUI/ml and sperm concentration <40 mil/ml had good predictive ability for pathologic second sperm anlysis (all AUC >0.8). Considering 1-point for each of the previous variables, the chances of a pathological second analysis increased from 38.8% to 74.6%, 77.3% and 100% among patients with risk scores of 0, 1, 2 and 3, respectively. CONCLUSIONS: Approximately 60% of infertile men with a first normal semen analysis had a pathological second test. Predictors for pathological second test were small testicular volumes, high FSH, and low sperm concentration at first analysis. A risk score based on these parameters could be useful to identify infertile men with a first normal semen analysis that deserve a second test. Source of Funding: None © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e528-e528 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Luca Boeri More articles by this author Paolo Capogrosso More articles by this author Edoardo Pozzi More articles by this author Luigi Candela More articles by this author Federico Belladelli More articles by this author Walter Cazzaniga More articles by this author Giuseppe Fallara More articles by this author Daniele Cignoli More articles by this author Nicolò Schifano More articles by this author Eugenio Ventimiglia More articles by this author Gianmarco Colandrea More articles by this author Massimo Alfano More articles by this author Costantino Abbate More articles by this author Francesco Montorsi More articles by this author Andrea Salonia More articles by this author Expand All Advertisement Loading ...