ReviewThe world journal of men's health2022
Sperm Vitality and Necrozoospermia: Diagnosis, Management, and Results of a Global Survey of Clinical Practice.
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Review in The world journal of men's health, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers.
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23citing papers in PubMed
6.4field-weighted citation impact, top 3% of its field
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Who cites it
23 citing papers in PubMed, 47 citations in OpenAlex.
- Novel homozygous or compound heterozygous DNAH17 variants lead to male infertility characterized by multiple morphological abnormalities of the sperm flagella and asthenoteratozoospermia in humans.Asian journal of andrology · 2026Article
- Epidemiology, Etiopathogenesis, Diagnosis, and Treatment of Male Infertility-Current Trends and Future Directions: A Narrative Review.Medicina (Kaunas, Lithuania) · 2026Review
- Effects ofJournal of parasitology research · 2026Article
- CAPZA1 deficiency disrupts sperm flagellar structure and motility, potentially involving the p300/SLC7A11 pathway.Frontiers in endocrinology · 2026Article
- Can the Quality of Semen Affect the Fertilisation Indices of Turkey Eggs?International journal of molecular sciences · 2025Article
- Andrological profile of infertile men with necrozoospermia (phenotypical features and etiologies): retrospective analysis of a cohort of more than 300 patients.BMC urology · 2025Article
- Observational
- Redo testicular sperm aspiration (TESA) in men with severe oligoasthenoteratozoospermia (OAT) and obstructive azoospermia (OA).The Canadian journal of urology · 2025Article
- Silymarin as a promising antioxidant for sperm cryopreservation: a narrative review.Translational andrology and urology · 2025Review
- Protective Effect of Cinnamon (Cinnamomum zeylanicum) Extract on the Sperm Quality During Cool Storage of Ram Semen.Veterinary medicine and science · 2025Article
- Development of a predictive nomogram for microscopic inferior epigastric vein-internal spermatic vein surgery in male infertility with combined varicocele and nutcracker syndrome.American journal of translational research · 2025Article
- Secondary infertility due to necrospermia in men with autosomal-dominant polycystic kidney disease: a report of two cases.CEN case reports · 2024Article
- Lipidomics random forest algorithm of seminal plasma is a promising method for enhancing the diagnosis of necrozoospermia.Metabolomics : Official journal of the Metabolomic Society · 2024Article
- The Global Andrology Forum (GAF): Structure, Roles, Functioning and Outcomes: An Online Model for Collaborative Research.The world journal of men's health · 2024Article
- Article
- Nomograms for Predicting Postoperative Sperm Improvements in Varicocele Patients.European urology open science · 2024Article
- Sixth edition of the World Health Organization laboratory manual of semen analysis: Updates and essential take away for busy clinicians.Arab journal of urology · 2024Article
- Impact of high-risk and low-risk human papillomavirus infections on the male genital tract: effects on semen inflammation and sperm quality.Frontiers in cellular and infection microbiology · 2024Article
- Membrane-bound receptor for advanced glycation end products (RAGE) is a stable biomarker of low-quality sperm.Human reproduction open · 2024Article
- Metabonomic analysis of seminal plasma in necrozoospermia patients based on liquid chromatography-mass spectrometry.Translational andrology and urology · 2023Article
Corrections and comments
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Authors and funding
67 authors at 20 institutions in 30 countries.
Ashok AgarwalAmerican Center for Reproductive Medicine, Cleveland Clinic, Cleveland, OH, USA. agarwaa@ccf.org.ORCID https://orcid.org/0000-0003-0585-1026
Rakesh K SharmaAmerican Center for Reproductive Medicine, Cleveland Clinic, Cleveland, OH, USA.ORCID https://orcid.org/0000-0002-9664-6978
Sajal GuptaAmerican Center for Reproductive Medicine, Cleveland Clinic, Cleveland, OH, USA.ORCID https://orcid.org/0000-0001-6487-9681
Florence BoitrelleReproductive Biology, Fertility Preservation, Andrology, CECOS, Poissy Hospital, Poissy, France.ORCID https://orcid.org/0000-0002-5322-0141
Renata FinelliAmerican Center for Reproductive Medicine, Cleveland Clinic, Cleveland, OH, USA.ORCID https://orcid.org/0000-0002-5926-6407
Neel ParekhDepartment of Urology, Cleveland Clinic, Cleveland, OH, USA.ORCID https://orcid.org/0000-0002-6218-9254
Damayanthi DurairajanayagamDepartment of Physiology, Faculty of Medicine, Universiti Teknologi MARA, Sungai Buloh Campus, Selangor, Malaysia.ORCID https://orcid.org/0000-0001-9049-0215
Ramadan SalehDepartment of Dermatology, Venereology and Andrology, Faculty of Medicine, Sohag University, Sohag, Egypt.ORCID https://orcid.org/0000-0003-0503-3533
Mohamed ArafaAmerican Center for Reproductive Medicine, Cleveland Clinic, Cleveland, OH, USA.ORCID https://orcid.org/0000-0003-0107-8857
Chak Lam ChoSH Ho Urology Center, Department of Surgery, Chinese University of Hong Kong, Hong Kong.ORCID https://orcid.org/0000-0003-2520-6833
Ala'a FarkouhAmerican Center for Reproductive Medicine, Cleveland Clinic, Cleveland, OH, USA.ORCID https://orcid.org/0000-0002-0362-9109
Amarnath RambhatlaDepartment of Urology, Vattikuti Urology Institute, Henry Ford Health System, Detroit, MI, USA.ORCID https://orcid.org/0000-0002-1383-6670
Ralf HenkelAmerican Center for Reproductive Medicine, Cleveland Clinic, Cleveland, OH, USA.ORCID https://orcid.org/0000-0003-1128-2982
Paraskevi VogiatziAndromed Health & Reproduction, Fertility Diagnostics Laboratory, Maroussi, Greece.ORCID https://orcid.org/0000-0001-9971-1619
Nicholas TadrosDivision of Urology, Southern Illinois University School of Medicine, Springfield, IL, USA.ORCID https://orcid.org/0000-0002-2272-235X
Parviz KavoussiAustin Fertility and Reproductive Medicine/Westlake IVF, Department of Urology, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA.ORCID https://orcid.org/0000-0001-7390-5837
Edmund KoDepartment of Urology, Loma Linda University Health, Loma Linda, CA, USA.ORCID https://orcid.org/0000-0002-7465-3616
Kristian LeisegangDepartment of Physiology, School of Natural Medicine, Faculty of Community and Health Sciences, University of the Western Cape, Bellville, South Africa.ORCID https://orcid.org/0000-0002-3003-8048
Hussein KandilFakih IVF Fertility Center, Abu Dhabi, UAE.ORCID https://orcid.org/0000-0002-5549-3274
Ayad PalaniDepartment of Biochemistry, College of Medicine, University of Garmian, Kalar, Iraq.ORCID https://orcid.org/0000-0001-7806-9903
Gianmaria SalvioDepartment of Endocrinology and Metabolic Diseases, Polytechnic University of Marche, Ancona, Italy.ORCID https://orcid.org/0000-0001-9290-5699
Taymour MostafaDepartment of Andrology, Sexology and STIs, Faculty of Medicina, Cairo University, Cairo, Egypt.ORCID https://orcid.org/0000-0003-3627-0662
Osvaldo RajmilDepartment of Andrology, Fundacio Puigvert, Barcelona, Spain.ORCID https://orcid.org/0000-0003-1987-9206
Saleem Ali BanihaniDepartment of Medical Laboratory Sciences, Faculty of Applied Medical Sciences, Jordan University of Science and Technology, Irbid, Jordan.ORCID https://orcid.org/0000-0002-6830-6247
Samantha SchonDivision of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, MI, USA.ORCID https://orcid.org/0000-0001-5524-3649
Tan V LeDepartment of Andrology and Urology, Pham Ngoc Thach University of Medicine, Ho Chi Minh City, Viet Nam.ORCID https://orcid.org/0000-0003-1766-7453
Ponco BirowoDepartment of Urology, Cipto Mangunkusumo General Hospital, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia.ORCID https://orcid.org/0000-0003-2934-6753
Gökhan ÇekerDepartment of Urology, Samsun Vezirköprü State Hospital, Samsun, Turkey.ORCID https://orcid.org/0000-0002-7891-9450
Juan AlvarezCentro ANDROGEN, La Coruña, Spain.ORCID https://orcid.org/0000-0002-4851-9579
Juan Manuel Corral MolinaServicio de Urología, Hospital Clínico de Barcelona, Barcelona, Spain.ORCID https://orcid.org/0000-0003-1423-0256
Christopher C K HoDepartment of Surgery, School of Medicine, Faculty of Health and Medical Sciences, Taylor's University, Subang Jaya, Malaysia.ORCID https://orcid.org/0000-0002-8757-6867
Aldo E CalogeroDepartment of Clinical and Experimental Medicine, University of Catania, Catania, Italy.ORCID https://orcid.org/0000-0001-6950-335X
Kareim KhalafallaDepartment of Urology, Hamad Medical Corporation, Doha, Qatar.ORCID https://orcid.org/0000-0001-9476-4869
Mesut Berkan DuranDepartment of Urology, Samsun Training and Research Hospital, Samsun, Turkey.ORCID https://orcid.org/0000-0002-8597-2081
Shinnosuke KurodaAmerican Center for Reproductive Medicine, Cleveland Clinic, Cleveland, OH, USA.ORCID https://orcid.org/0000-0001-8890-0297
Giovanni M ColpiAndrology and IVF Unit, Procrea Institute, Lugano, Switzerland.ORCID https://orcid.org/0000-0003-1431-1777
Armand ZiniDepartment of Surgery, McGill University, Montreal, QC, Canada.ORCID https://orcid.org/0000-0002-2194-5578
Christina AnagnostopoulouIVF Clinic "Akeso-Embryo ART", Athens, Greece.ORCID https://orcid.org/0000-0003-0999-6484
Edoardo PescatoriAndrology and Reproductive Medicine Unit, Gynepro Medical, Bologna, Italy.ORCID https://orcid.org/0000-0002-9326-5598
Eric ChungDepartment of Urology, Princess Alexandra Hospital, University of Queensland, Brisbane, QLD, Australia.ORCID https://orcid.org/0000-0003-3373-3668
Ettore CaroppoReproductive and IVF Unit, Andrology Outpatients Clinic, ASL Bari, Conversano (Ba), Italy.ORCID https://orcid.org/0000-0001-8411-2736
Fotios Dimitriadis1st Urology Department, School of Medicine, Aristotle University, Thessaloniki, Greece.ORCID https://orcid.org/0000-0003-1198-9144
Germar-Michael PinggeraDepartment of Urology, Innsbruck Medical University, Innsbruck, Austria.ORCID https://orcid.org/0000-0001-6463-2494
Gian Maria BusettoDepartment of Urology and Renal Transplantation, University of Foggia, Ospedali Riuniti of Foggia, Foggia, Italy.ORCID https://orcid.org/0000-0002-7291-0316
Giancarlo BalerciaDepartment of Endocrinology and Metabolic Diseases, Polytechnic University of Marche, Ancona, Italy.ORCID https://orcid.org/0000-0003-1286-1521
Haitham ElbardisiDepartment of Urology, Hamad Medical Corporation, Doha, Qatar.ORCID https://orcid.org/0000-0003-3902-7924
Hisanori TaniguchiDepartment of Urology and Andrology, Kansai Medical University, Hirakata, Osaka, Japan.ORCID https://orcid.org/0000-0002-7404-0369
Hyun Jun ParkDepartment of Urology, Pusan National University School of Medicine, Busan, Korea.ORCID https://orcid.org/0000-0003-0566-9574
Israel Maldonado RosasCitmer Reproductive Medicine, IVF LAB, Mexico City, Mexico.ORCID https://orcid.org/0000-0003-2765-6176
Jean de la RosetteDepartment of Urology, Medipol Mega University Hospital, Istanbul, Turkey.ORCID https://orcid.org/0000-0002-6308-1763
Jonathan RamsayDepartment of Andrology, Hammersmith Hospital, London, UK.ORCID https://orcid.org/0000-0002-2403-7698
Kasonde BowaDepartment of Urology, Michael Chilufya Sata Copperbelt University School of Medicine, Ndola, Zambia.ORCID https://orcid.org/0000-0001-7032-7998
Mara SimopoulouDepartment of Experimental Physiology, School of Health Sciences, Faculty of Medicine, National and Kapodistrian University of Athens, Athens, Greece.ORCID https://orcid.org/0000-0002-1000-9100
Marcelo Gabriel RodriguezDepartamento Docencia e Investigación, Hospital Militar Campo de Mayo, Universidad Barcelo, Buenos Aires, Argentina.ORCID https://orcid.org/0000-0003-2437-7833
Marjan SabbaghianDepartment of Andrology, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran.ORCID https://orcid.org/0000-0001-9439-268X
Marlon MartinezSection of Urology, University of Santo Tomas Hospital, Manila, Philippines.ORCID https://orcid.org/0000-0002-1191-8154
Mohamed Ali Sadighi GilaniDepartment of Andrology, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran.ORCID https://orcid.org/0000-0001-6168-8599
Mohamed S Al-MarhoonDepartment of Surgery, Urology Division, Sultan Qaboos University, Muscat, Oman.ORCID https://orcid.org/0000-0002-8397-1560
Raghavender KosgiDepartment of Urology and Andrology, AIG Hospitals, Gachibowli, Hyderabad, India.ORCID https://orcid.org/0000-0002-2178-0857
Rossella CannarellaDepartment of Clinical and Experimental Medicine, University of Catania, Catania, Italy.ORCID https://orcid.org/0000-0003-4599-8487
Sava MicicDepartment of Andrology, Uromedica Polyclinic, Belgrade, Serbia.ORCID https://orcid.org/0000-0001-9037-3318
Shinichiro FukuharaDepartment of Urology, Graduate School of Medicine, Osaka University, Osaka, Japan.ORCID https://orcid.org/0000-0003-1336-4316
Sijo ParekattilAvant Concierge Urology & University of Central Florida, Winter Garden, FL, USA.ORCID https://orcid.org/0000-0001-6847-8826
Sunil JindalDepartment of Andrology and Reproductive Medicine, Jindal Hospital, Meerut, India.ORCID https://orcid.org/0000-0002-8088-8710
Taha Abo-Almagd Abdel-MeguidDepartment of Urology, Faculty of Medicine, Minia University, Minia, Egypt.ORCID https://orcid.org/0000-0002-8070-4088
Yoshiharu MorimotoHORAC Grand Front Osaka Clinic, Osaka, Japan.ORCID https://orcid.org/0000-0003-2834-2726
Rupin ShahDivision of Andrology, Department of Urology, Lilavati Hospital and Research Centre, Mumbai, India.ORCID https://orcid.org/0000-0002-7868-5949
Cleveland Clinic · USMarche Polytechnic University · ITRoyan Institute · IRSamsun University · TRUniversity of Catania · ITAristotle University of Thessaloniki · GRAsian Institute of Gastroenterology · INCairo University · EGChinese University of Hong Kong · HKCopperbelt University · ZMGynePro Medical · ITHamad Medical Corporation · QAHammersmith Hospital · GBHenry Ford Health System · USHospital Clínic de Barcelona · ESInformation Group on Reproductive Choice · MXInnsbruck Medical University · ATIstanbul Medipol University · TRIVI Middle East Fertility Clinic · AEJordan University of Science and Technology · JO
Funding
American Center for Reproductive Medicine
Abstract
Sperm vitality testing is a basic semen examination that has been described in the World Health Organization (WHO) Laboratory Manual for the Examination and Processing of Human Semen from its primary edition, 40 years ago. Several methods can be used to test sperm vitality, such as the eosin-nigrosin (E-N) stain or the hypoosmotic swelling (HOS) test. In the 6th (2021) edition of the WHO Laboratory Manual, sperm vitality assessment is mainly recommended if the total motility is less than 40%. Hence, a motile spermatozoon is considered alive, however, in certain conditions an immotile spermatozoon can also be alive. Therefore, the differentiation between asthenozoospermia (pathological decrease in sperm motility) and necrozoospermia (pathological decrease in sperm vitality) is important in directing further investigation and management of infertile patients. The causes leading to necrozoospermia are diverse and can either be local or general, testicular or extra-testicular. The andrological management of necrozoospermia depends on its etiology. However, there is no standardized treatment available presently and practice varies among clinicians. In this study, we report the results of a global survey to understand current practices regarding the physician order of sperm vitality tests as well as the management practices for necrozoospermia. Laboratory and clinical scenarios are presented to guide the reader in the management of necrozoospermia with the overall objective of establishing a benchmark ranging from the diagnosis of necrozoospermia by sperm vitality testing to its clinical management.
Indexed as
AsthenozoospermiaEosine Yellowish-(YS)InfertilityNigrosinSpermatozoaVitality
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