Department of Urology, Foundation IRCCS Ca' Granda, Maggiore Policlinico Hospital, Milan, Italy.
Unit of Urology, Division of Experimental Oncology, URI, IRCCS Ospedale San Raffaele, Milan, Italy.
Andrology. 2022 Sep;10(6):1134-1142. doi: 10.1111/andr.13213. Epub 2022 Jun 30.
In 2021, the World Health Organization (WHO) has provided the latest update on processing and evaluating semen analysis.
To assess (i) the rate of discordance in semen parameters categorization across three different WHO reference values (namely WHO21, 2010 and 1999) and (ii) the clinical differences among discordant semen analyses from a cohort of primary infertile men.
Data from 788 infertile men were analyzed. Semen parameters were interpreted based on WHO21, WHO10, and WHO99 reference criteria. Pregnancy outcomes with assisted reproductive techniques (ART) were available for 110 (14%) patients. Descriptive statistics was applied to describe potential differences among the three consecutive WHO references criteria.
Semen parameters categorizations were highly different across the three groups (p < 0.001). Of all, 271 (42.2%) patients had normal semen parameters according to WHO10 but were pathologic when considered with WHO21 reference criteria (namely, men with increased semen abnormalities). Infertile men with increased semen abnormalities had lower testicular volume (p < 0.001) but higher FSH (p < 0.01) and LH (p < 0.001) values than those who had no change in terms of semen parameters categorization. Negative ART outcomes were more frequently reported in men with worsening semen parameters compared with those with confirmed semen parameters at WHO21 versus WHO10 (26.8% vs. 49%, p = 0.03). Conversely, infertile men with worsening semen parameters at WHO21 versus WHO99 were similar in terms of clinical and hormonal characteristics compared with those with the same rate of semen abnormalities.
One out of three infertile men showed worsened semen categorization according to WHO21 versus WHO10. Infertile men with worsening of semen parameters had worse clinical and hormonal characteristics than those with confirmed numbers of semen abnormalities. Moreover, live birth rates were lower in men with worsening semen abnormalities as for WHO21.
2021 年，世界卫生组织（WHO）对精液分析处理和评估提供了最新更新。
评估（i）三种不同 WHO 参考值（即 WHO21、2010 和 1999）下精液参数分类的不一致率，以及（ii）原发性不育男性队列中不一致的精液分析的临床差异。
分析了 788 名不育男性的数据。根据 WHO21、WHO10 和 WHO99 参考标准解释精液参数。有 110 名（14%）患者可获得辅助生殖技术（ART）的妊娠结局。应用描述性统计分析来描述三个连续的 WHO 参考标准之间的潜在差异。
精液参数分类在三组之间差异很大（p<0.001）。在所有患者中，根据 WHO10，271 名（42.2%）患者的精液参数正常，但当参考 WHO21 参考标准时，这些患者的精液参数为异常（即精液异常增加的男性）。精液参数分类无变化的不育男性睾丸体积较小（p<0.001），但 FSH（p<0.01）和 LH（p<0.001）值较高。与 WHO21 时精液参数分类确认正常的男性相比，精液参数恶化的男性 ART 结局更差（26.8%vs.49%，p=0.03）。相反，与 WHO21 时精液参数异常恶化的男性相比，WHO99 时精液参数异常恶化的男性在临床和激素特征方面相似。
三分之一的不育男性根据 WHO21 与 WHO10 的标准，精液分类恶化。与确认精液异常数量的男性相比，精液参数恶化的不育男性具有更差的临床和激素特征。此外，在 WHO21 时精液异常恶化的男性活产率较低。
