Evaluation of sperm function. What is available in the modern andrology laboratory?

Tests of sperm function markedly improve the clinician's ability to diagnose male factor infertility accurately. An understanding of the patient's sperm defect may improve the clinical management of male infertility. A wide spectrum of therapeutic options is available to the urologist treating the infertile male. IVF is now routinely employed for many types of male factor infertility with promising results. Micromanipulation has permitted men who, in the not so distant past, were considered infertile to experience fatherhood. In light of these promising therapeutic advances, accurate assessment of sperm function becomes crucial. Treatment options may be selected on the basis of specific functional defects of sperm. Sperm with an inability to bypass cervical mucus may be adequately treated with IUI. Oligospermic men with sperm capable of ova penetration can be treated with IVF, whereas men whose sperm are incapable of zona binding/penetration may be treated with micromanipulation. Sperm function assays provide a rationale for the selection of specific therapies to treat or bypass identified defects, and by providing comprehensive and accurate diagnosis, they make possible individually tailored therapies. Such individualized treatment choices may improve success rates for many male factor patients.