Clinical Interpretation of Semen Analysis

Semen analysis is a fundamental step in the evaluation of the male fertility potential. However, fertility is a “couple-concept” implying the importance of the partner’s fertility status. In fact, a part from extreme conditions (e.g., azoospermia, necrozoospermia, total immotile spermatozoa, etc.) sperm parameters are not fully predictive for natural pregnancy. Semen analysis is divided into macroscopic and microscopic evaluation, and it provides information on the efficiency of spermatogenesis and the integrity of post-testicular structures. Based on the WHO reference values, it is possible to identify alterations of semen parameters, which may derive from many different etiologies. It is essential that the laboratory performs the analysis according to the current WHO guidelines and participate at an external quality control (EQC) program. The clinical interpretation of these alterations is the focus of this chapter.