A Review Diagnosing Male Infertility: Beyond Conventional Semen Analysis

Abstract

Infertility, defined as the inability of couples to conceive after one year of consistent, unprotected sexual contact, is a widespread concern affecting a significant portion of the population. Notably, between 14 to 17% of couples may encounter infertility at some point during their reproductive journey. This review delves into the realm of diagnosing male infertility beyond conventional semen analysis. Conventional semen analysis, which is a globally accepted tool for male infertility, primarily focuses on assessing sperm count, motility, viability, and morphology, leaving certain aspects of sperm functionality unexplored. These limitations necessitate the integration of advanced semen analysis techniques to provide a more comprehensive evaluation. Advanced semen analysis encompasses a range of sophisticated tests that probe deeper into the intricacies of male fertility. These tests include assessing sperm penetration capabilities, acrosomal discharge, and spermatozoa Reactive Oxygen Species (ROS) levels. Moreover, advanced semen analysis encompasses tests like sperm chromatin structure assay, DNA damage assessment, sperm proteomics, sperm metabolomics, and high sperm magnification microscopy, all of which shed light on various facets of sperm function and quality. While advanced semen analysis techniques offer a more comprehensive understanding of male infertility, their uptake and utilization in clinical practice have been limited. This review aims to elucidate the roles, merits, and drawbacks of both conventional and advanced semen analysis in diagnosing male infertility. This review sheds light on the strengths and weaknesses of each approach, it promotes a more nuanced approach to male infertility diagnosis, enhancing the prospects of successful conception for infertility challenged couples.