Sperm Morphology Assessment in the Era of Intracytoplasmic Sperm Injection: Reliable Results Require Focus on Standardization, Quality Control, and Training

Ashok Agarwal, Rakesh Sharma, Sajal Gupta, Renata Finelli, Neel Parekh, Manesh Kumar Panner Selvam, Ralf Henkel, Damayanthi Durairajanayagam, Camila Pompeu, Sarah Madani, Andrea Belo, Neha Singh, Simryn Covarrubias, Sara Darbandi, Raha Sadeghi, Mahsa Darbandi, Paraskevi Vogiatzi, Florence Boitrelle, Mara Simopoulou, Ramadan SalehMohamed Arafa, Ahmad Majzoub, Hussein Kandil, Armand Zini, Edmund Ko, Juan G. Alvarez, Marlon Martinez, Jonathan Ramsay, Sunil Jindal, Gian Maria Busetto, Hassan Sallam, Israel Maldonado, Christina Anagnostopoulou, Marco G. Alves, Pallav Sengupta, Kambiz Gilany, Donald P. Evenson, Sheena E.M. Lewis, Jaime Gosalvez, Rafael F. Ambar, Rupin Shah

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Abstract

Semen analysis is the first, and frequently, the only step in the evaluation of male fertility. Although the laboratory procedures are conducted according to the World Health Organization (WHO) guidelines, semen analysis and especially sperm morphology assessment is very difficult to standardize and obtain reproducible results. This is mainly due to the highly subjective nature of their evaluation. ICSI is the choice of treatment when sperm morphology is severely abnormal (teratozoospermic). Hence, the standardization of laboratory protocols for sperm morphology evaluation represents a fundamental step to ensure reliable, accurate and consistent laboratory results that avoid misdiagnoses and inadequate treatment of the infertile patient. This article aims to promote standardized laboratory procedures for an accurate evaluation of sperm morphology, including the establishment of quality control and quality assurance policies. Additionally, the clinical importance of sperm morphology results in assisted reproductive outcomes is discussed, along with the clinical management of teratozoospermic patients.
Original languageEnglish
Article numbere36
JournalThe World Journal of Men's Health
Volume39
DOIs
Publication statusPublished - 17 Jun 2021

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