A Novel Approach to Improving the Reliability of Manual Semen Analysis: A Paradigm Shift in the Workup of Infertile Men

Abstract

Conventional semen analysis (SA) is an essential component of the male infertility workup, but requires laboratories to rigorously train and monitor technicians as well as regularly perform quality assurance assessments. Without such measures there is room for error and, consequently, unreliable results. Furthermore, clinicians often rely heavily on SA results when making diagnostic and treatment decisions, however conventional SA is only a surrogate marker of male fecundity and does not guarantee fertility. Considering these challenges, the last several decades have seen the development of many advances in SA methodology, including tests for sperm DNA fragmentation, acrosome reaction, and capacitation. While these new diagnostic tests have improved the scope of information available to clinicians, they are expensive, time-consuming, and require specialized training. The latest advance in laboratory diagnostics is the measurement of seminal oxidation-reduction potential (ORP). The measurement of ORP in an easy, reproducible manner using a new tool called the Male Infertility Oxidative Stress System (MiOXSYS) has demonstrated ORP's potential as a feasible adjunct test to conventional SA. Additionally, the measurement of ORP by this device has been shown to be predictive of both poor semen quality and male infertility. Assessing ORP is a novel approach to both validating manual SA results and identifying patients who may benefit from treatment of male oxidative stress infertility.

Simplified sperm testing devices: a possible tool to overcome lack of accessibility and inconsistency in male factor infertility diagnosis. An opportunity for low- and middle- income countries.

“…DNA fragmentation index testing; seminal oxidation potential), MSA remains the cornerstone, not only for diagnosis, but also for the choice of treatment in cases of male subfertility ( Oehninger and Ombelet, 2019 ). Therefore, proper application of methodologies and accurate measure of basic sperm parameters (concentration, motility and morphology) when performing MSA is of paramount importance ( Ombelet et al, 1997a ; Keel, 2004 ; Douglas et al, 2019 ).…”

“…In spite of these advantages, a common denominator between all these devices remains the limited outcomes measured: apart from volume, concentration, and motility nothing else is assessed. As mentioned before, these parameters alone are not sufficient to disclose male infertility and morphology scoring is not available although its value might be important ( Kruger et al, 1988 ; Ombelet et al, 1997b ; Sallam et al, 2003 ; Kanakasabapathy et al, 2017 ; Douglas et al, 2019 ). Additionally, as for CASA, technical difficulties such as size-based cell misidentification, when measuring sperm concentration in samples presenting higher-than- average numbers of non-sperm cells (i.e.…”

“Online” and “at-home” versus traditional models of health care: enhancing access or impeding optimal therapeutics?

“…With the development of the Y0 smartphone-based computer-assisted SA system, which uses the smartphone’s camera and light source to measure motile sperm concentration, there’s great potential to support home testing and evaluate fecundity in a young generation familiar with information technology without formal training ( 14 ). Both the Y0 device and paper-based devices claim to show 97.8% and 100% agreement with the results of computer-assisted SA, respectively ( 7 , 9 ).…”

Transcriptomic Profiling of Buffalo Spermatozoa Reveals Dysregulation of Functionally Relevant mRNAs in Low-Fertile Bulls

“…Several studies tried to identify the most important sperm phenotypic characteristics associated with sperm-fertilizing potential (4,5); however discriminating low-fertile bulls from high-fertile bulls remains to continue as a challenge. Therefore, advanced semen quality assessment techniques are needed to achieve an accurate diagnosis of bull fertility (6). Recent evidences indicate existence of specific differences in sperm functional attributes and sperm molecules such as mRNAs (7), proteins (8), and metabolites (9) between high-and low-fertile bulls.…”