ArticleAndrology2022
The impact of different WHO reference criteria for semen analysis in clinical practice: Who will benefit from the new 2021 thresholds for normal semen parameters?
Article in Andrology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers.
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Who cites it
20 citing papers in PubMed, 31 citations in OpenAlex.
- Article
- Associations of Semen Quality with Essential and Non-Essential Elements in Seminal Fluid.Biological trace element research · 2026Article
- Integrating Sperm Microscopy, Environmental Exposures, and Lifestyle Factors for Male Fertility Analysis: Protocol for the Nippon Semen and Environmental Exposure Database (N-SEED) Cross-Sectional Study.JMIR research protocols · 2026Article
- A prospective study of semen quality and fecundability among North American couples planning pregnancy.Andrology · 2026Article
- Dietary antioxidants and micronutrient status in varicocele-associated male infertility: oxidative stress-mediated effects on semen quality.Frontiers in nutrition · 2026Article
- GC-MS/MS analysis of seminal plasma PUFAs in distinct subgroups of infertile men: diagnostic potential and insight into mechanisms of male infertility.Scientific reports · 2025Observational
- Contemporary Diagnostic Work-Up for Male Infertility: Emphasizing Comprehensive Baseline Assessment.The world journal of men's health · 2025Review
- Association Between Zinc Levels and the Impact of Its Deficiency on Idiopathic Male Infertility: An Up-to-Date Review.Antioxidants (Basel, Switzerland) · 2025Review
- Idiopathic male infertility - what are we missing?Arab journal of urology · 2025Article
- Article
- The Effects of Varicocelectomy on Sperm DNA Fragmentation and Conventional Semen Parameters in Men with Severe Oligoasthenoteratozoospermia: A Prospective Study.International journal of fertility & sterility · 2024Article
- Low Birth Weight is Associated with Sperm DNA Fragmentation and Assisted Reproductive Technology Outcomes in Primary Infertile Men: Results of a Cross-Sectional Study.The world journal of men's health · 2024Article
- Next-generation sequencing analysis of semen microbiome taxonomy in men with nonobstructive azoospermia vs. fertile controls: a pilot study.F&S science · 2023Article
- Paternal Age Matters: Association with Sperm Criteria's- Spermatozoa DNA Integrity and Methylation Profile.Journal of clinical medicine · 2023Article
- Efficacy of Clomiphene Citrate Versus Enclomiphene Citrate for Male Infertility Treatment: A Retrospective Study.Cureus · 2023Article
- Article
- Article
- Clinically Meaningful Improvements in Sperm DNA Fragmentation Severity in Infertile Men Treated with Superoxide Dismutase Supplementation: A Single-Center Experience.Journal of clinical medicine · 2022Article
- Article
- Exploring the Association between Arsenic Exposure and Sperm Quality: A Systematic Review and Meta-analysis.Journal of human reproductive sciencesReview
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Authors and funding
11 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundIn 2021, the World Health Organization (WHO) has provided the latest update on processing and evaluating semen analysis.
objectivesTo 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. MATERIALS AND
methodsData 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.
resultsSemen 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.
conclusionsOne 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.
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