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Unexplained Infertility pp 13–20Cite as

Controversies Surrounding the 2010 World Health Organization Cutoff Values for Human Semen Characteristics and Its Impact on Unexplained Infertility

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Abstract

In 2010, the World Health Organization (WHO) published new reference criteria for human semen characteristics. Important methodological issues, including patient selection and methods for semen assessments, elucidate why reference values are markedly lower than those earlier reported. The validity of the new criteria as a representation of the semen quality of fertile men has been questioned as they have been generated from a small group of recent fathers of restricted geographic regions. The 2010 WHO criteria are likely to have a significant clinical effect as more men will be classified as having unexplained male infertility. This may lead to a deferment of referral and could delay the definitive diagnosis and management of the infertile couple. Due to the several inherent limitations of semen analysis as a surrogate marker of male infertility, physicians should exercise caution when interpreting results. Semen analysis alone is usually insufficient for the diagnosis, as it does not account for sperm dysfunction, such as immature chromatin, oxidative stress (OS), and DNA damage. A male infertility evaluation must go far beyond a simple semen analysis, as it has to be complemented with a proper physical examination, a comprehensive history taking, and relevant endocrine, genetic, and other investigations.

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Authors and Affiliations

  1. ANDROFERT, Andrology and Human Reproduction Clinic, Referral Center for Male Reproduction, Avenida Dr. Heitor Penteado 1464, Campinas, São Paulo, Brazil

    Sandro C. Esteves MD, PhD

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  1. Sandro C. Esteves MD, PhD
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Correspondence to Sandro C. Esteves MD, PhD .

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Editors and Affiliations

  1. Ronald O. Perelman and Claudia Cohen Center for Reproductive Medicine, Weill Cornell Medical College, New York, New York, USA

    Glenn L. Schattman

  2. Andrology and Human Reproduction Clinic Referral Center for Male Reproduction, ANDROFERT, Campinas, São Paulo, Brazil

    Sandro C. Esteves

  3. Andrology Center & Center for Reproductive Medicine, Lerner College of Medicine Case Western Reserve University, Cleveland, Ohio, USA

    Ashok Agarwal

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Esteves, S. (2015). Controversies Surrounding the 2010 World Health Organization Cutoff Values for Human Semen Characteristics and Its Impact on Unexplained Infertility. In: Schattman, G., Esteves, S., Agarwal, A. (eds) Unexplained Infertility. Springer, New York, NY. https://doi.org/10.1007/978-1-4939-2140-9_3

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  • DOI: https://doi.org/10.1007/978-1-4939-2140-9_3

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