ArticleF&S reports2021
Assessing the clinical value of the Kruger strict morphology criteria over the World Health Organization fourth edition criteria.
Article in F&S reports, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
5 citing papers in PubMed.
- The link between diabetes and male infertility: mechanisms and implications.Scientific reports · 2026Article
- Epidemiology, Etiopathogenesis, Diagnosis, and Treatment of Male Infertility-Current Trends and Future Directions: A Narrative Review.Medicina (Kaunas, Lithuania) · 2026Review
- Integrative Single-Cell Analysis Reveals Iron Overload-Induced Senescence and Metabolic Reprogramming in Ovarian Endometriosis-Associated Infertility.Advanced science (Weinheim, Baden-Wurttemberg, Germany) · 2025Article
- Article
- Decline of Sperm Quality over the Last Two Decades in the South of Europe: A Retrospective Study in Infertile Patients.Biology · 2022Article
Corrections and comments
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo assess if the newer Kruger strict morphology (WHO5; normal ≥4%) adds any clinical value beyond the criteria of the World Health Organization fourth edition (WHO4; normal ≥14%).
designRetrospective study.
settingTertiary hospital. PATIENTS: Men without known azoospermia who had semen analysis (SA) collected over a 10-year period of time.
interventionsMorphology classification under Kruger WHO5 strict criteria and WHO4 criteria.
main outcome measuresCorrelation between the WHO5 and WHO4 morphological classifications.
resultsA total of 4,510 SAs were identified during the study period. Of these, both Kruger WHO5 and WHO4 morphologies were included in 932 SAs (20.7%) from a total of 691 men. The median age of the men was 37 years (interquartile range, 32.0-43.8 years). The mean (±SD) semen volume, sperm concentration, and motility were 2.6 ± 1.4 mL, 50.0 ± 35.6 × 10
conclusionsThe Kruger WHO5 and WHO4 morphologic criteria correlate closely. Only two men (0.4%) with an abnormal Kruger morphology had normal WHO4 morphology. Given the limited predictive value of sperm morphology, the additional cost and effort of Kruger criteria may not be warranted in lieu of, or in addition to, the WHO4 classification.
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