Semen analysis at the turn of the century: an evaluation of potential uses of new sperm function assays.

Semen analysis is a critical assay in the evaluation of infertility and may yield critical information regarding the etiology and prognosis of many types of reduced male fertility. However, basic semen analysis does not directly measure sperm fertilizing capacity, or many of the biochemical events both prior to and subsequent to fertilization. In the last two decades numerous assays of sperm function have been developed. These assays can be classified as: 1) Assays of general biochemistry and ultrastructure, 2) Assays of zona binding and oocyte penetration, and 3) Assays of postpenetration events. Sperm function assays not only allow an accurate diagnosis of many infertilities not diagnosed by the semen analysis, but can also lead to improved treatment modalities. In this review, basic semen analysis and many sperm function assays are briefly reviewed. Novel uses of sperm function are demonstrated in brief case studies.