Diagnostic value of advanced semen analysis in evaluation of male infertility

CAPSULE

Contributors: Donny Eka Putra, MD (Indonesia), and

Ria Margiana, MD (Indonesia)

Commentary:

Advanced semen analysis goes beyond the basic parameters assessed in a standard semen analysis. It includes additional test that can provide information about etiology of male infertility and prediction the reproductive success in couples trying to have spontaneous pregnancy or couples undergoing assisted reproductive technologies (ART). These advanced tests offer a more detailed analysis of sperm function and quality, including oxidative stress (OS), and sperm DNA fragmentation (SDF). The present article summarizes diagnostic value of advanced semen analysis, including most commonly used sperm function tests, along with assays used to assess OS and SDF in order to make comprehensive view of male reproductive health.

A critical gain of sophisticated semen evaluation is that it may evaluate male infertility in greater depth and nuance, so that a more precise and individualized diagnosis is viable, which may bring about customized therapeutic regimens that enhance patients' prognoses. However, A crucial downside is the heightened rate and intricacy of those methodologies compared to standard semen analysis.

From a clinical view, the medical integration of superior semen analysis has an awesome capacity for reinforcing diagnoses and remedies aimed at male infertility by identifying the root causes of infertility. Furthermore, modern strategies are integrated to fill the gaps left using traditional semen evaluation, providing physicians with a complete toolkit to realize the complexities of male reproductive health. Thirdly, the supply emphasizes the importance of standardization and continuous studies in advanced semen evaluation to set up typically identified procedures and reference ranges. This is critical for ensuring consistent and dependable consequences across different laboratories.

There are popular sperm function tests available: sperm capacitation and acrosome reaction, sperm zona pellucida binding test, hypo-osmotic swelling test, and anti-sperm antibody test. Additionally, sperm quality can be assessed by SDF test as well as tests that measure reactive oxygen species (ROS), OS, and oxidation-reduction potential (ORP). All these tests can help identify specific problems that could affect male fertility that might not be apparent from basic semen analysis. However, there are some limitations to these advanced tests. First, there are not standardized methodologies of these advanced tests yet. Second, the interpretation with these tests requires expertise and analyzed by qualified healthcare professional experienced in male fertility assessment. Third, not all healthcare facilities or fertility clinics offer advanced semen analysis, due to cost and availability of specialized equipment.

In the era of invitro fertilization (IVF), the role of advanced semen analysis became prominent. While providing detailed information about sperm quality and function, aiding the selection of the best sperm for injection, it is not always a definitive predictor for IVF success. The other factors, including female factors fertility status and embryology labs expertise, also play important role in IVF success.

Considering the importance diagnostic values of advanced semen analysis and their downsides, the clinician should interpret and integrate these essentials information with other clinical assessment (medical history, physical examination, hormone test, and other fertility evaluation) to design individualized treatment strategies.

Key Takeaways:

The article by Barbăroșie et al. underscores the importance of integrating advanced semen analysis techniques into the evaluation of male infertility. Advanced semen analysis provides detailed insights into male fertility, assessing parameters beyond basic count and motility, such as sperm morphology, OS, and DNA integrity, crucial for diagnosing and treating infertility. Incorporating these advanced analyses can significantly improve the diagnostic accuracy and treatment outcomes for male infertility cases. This approach allows for a deeper understanding of male reproductive health, enabling clinicians to tailor more effective treatment strategies for patients facing infertility challenges.