World J Mens Health.  2021 Apr;39(2):172-185. 10.5534/wjmh.190088.

A Novel Approach to Improving the Reliability of Manual Semen Analysis: A Paradigm Shift in the Workup of Infertile Men

Affiliations
  • 1American Center for Reproductive Medicine, Cleveland Clinic, OH, USA.
  • 2Texas College of Osteopathic Medicine, Fort Worth, TX, USA.
  • 3Department of Urology, Cleveland Clinic, Cleveland, OH, USA.
  • 4Department of Pediatrics, New York University School of Medicine, New York City, NY, USA.
  • 5Department of Medical Bioscience, University of the Western Cape, Bellville, South Africa.

Abstract

Conventional semen analysis (SA) is an essential component of the male infertility workup, but requires laboratories to rigorously train and monitor technicians as well as regularly perform quality assurance assessments. Without such measures there is room for error and, consequently, unreliable results. Furthermore, clinicians often rely heavily on SA results when making diagnostic and treatment decisions, however conventional SA is only a surrogate marker of male fecundity and does not guarantee fertility. Considering these challenges, the last several decades have seen the development of many advances in SA methodology, including tests for sperm DNA fragmentation, acrosome reaction, and capacitation. While these new diagnostic tests have improved the scope of information available to clinicians, they are expensive, time-consuming, and require specialized training. The latest advance in laboratory diagnostics is the measurement of seminal oxidation-reduction potential (ORP). The measurement of ORP in an easy, reproducible manner using a new tool called the Male Infertility Oxidative Stress System (MiOXSYS) has demonstrated ORP’s potential as a feasible adjunct test to conventional SA. Additionally, the measurement of ORP by this device has been shown to be predictive of both poor semen quality and male infertility. Assessing ORP is a novel approach to both validating manual SA results and identifying patients who may benefit from treatment of male oxidative stress infertility.

Keyword

Infertility; Male; MiOXSYS; Oxidation-reduction potential; Semen analysis; Semen analysis subjectivity
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