The Diagnostic and Prognostic Value of Traditional Semen Parameters

Abstract

A high-quality basic semen analysis represents one cornerstone in the investigation of the infertile couple. However, the clinical value of traditional semen parameters in the diagnosis of male fertility is the subject of considerable debate. Some authorities clearly hold the view that apart from a diagnosis of azoospermia (or very severe oligozoospermia), a basic semen assessment is of little clinical value. A recent example of this is reflected by the opinion of McDonough (1997, p. 587), who wrote: “traditional sperm analysis as a clinical test may become nothing more than an ancestral heirloom. It may be performed spasmodically by those who know how to do it, like a 1940 airshow or laparotomy, to remind us of the good old days. We have come to the end of something. Surely someone will want to carve a headstone for traditional sperm analysis or perhaps a mausoleum would be more fitting.” Is this a correct view? Well, it does have some merit. For example, the diagnosis of an abnormal or normal semen sample according to the World Health Organization (WHO) guidelines (1992) is somewhat artificial, and this dichotomy is of limited diagnostic value. It is well documented that a significant proportion of fertile men are diagnosed as abnormal if such criteria, i.e., WHO (1992), are used (Ombelet et al, 1997). The question that needs to be asked is the following: what is the clinical value of