**Nidhi Sharma and Sudakshina Chakrabarti**

Saveetha Medical College and Hospital, Chennai, India

> **Yona Barak** Dr. Yona Barak Laboratories, Israel

**Adrian Ellenbogen** Rappaport School of Medicine, Israel

**1**

Section 1

Physiology

Section 1 Physiology

**3**

**Chapter 1**

**Abstract**

Evaluation

to the chances of a couple to conceive.

**1. Introduction**

DNA fragmentation, genetic testing, lifestyle

The Sperm: Parameters and

*Tanya Milachich and Desislava Dyulgerova-Nikolova*

Sperm abnormalities are a major factor of human infertility. Since 1987, there are several references in different editions of World Health Organization (WHO) manual defining optimal sperm parameters. Over the years, many reproductive specialists have been constantly debating, suggesting and remodeling the frame values in those guidelines. Semen parameters have a leading role both in natural conception and assisted reproduction technologies (ART) outcomes. Deviations expressed in lower sperm count, impaired motility, abnormal morphology, and high percentage of sperm DNA fragmentation are linked to reduced chances to achieve pregnancy. In cases with low sperm count, severe oligoasthenozoospermia (OA) or azoospermia, karyotyping or evaluation with sperm aneuploidy test (SAT) could be an option and genetic counseling will be necessary if there is an obvious deviation or aberration (e.g., translocation, aneuploidy, etc.). Taking care of lifestyle factors as body mass index (BMI), diets, alcohol intake, smoking, using some additional nutrition and vitamin supplements might affect sperm parameters and contribute

**Keywords:** sperm count, OAT, azoospermia, ART, karyotyping, sperm aneuploidy,

The link between semen quality and fertility has been studied in humans since 1930 [1]. Semen analysis, as a standard laboratory test, gives basic information on spermatogenesis, secretory activity of the gonads and patency of the male genital tract [2]. The results obtained during the semen sample analysis could point out absence of spermatozoa, severe or mild deviation in sperm parameters or normal values for semen volume, sperm count and concentration, motility and morphology of the spermatozoa. Over the years many reproductive specialists have been constantly debating, suggesting and remodeling the frame values of the semen in reference to male fertility. Since 1987, there are several updates in different editions of World Health Organization (WHO) manuals defining the optimal sperm parameters with reference to pregnancy outcomes. The last (fifth) edition of the manual, published in 2010, defines serious decrease in cutoff values for sperm parameters related to chances of achieving pregnancy and thus its significance was widely discussed [3, 4]. One of the strong limitations of semen analysis and the defined fertility potential references in the last WHO edition is the lack of correlation with the female age, as only 30% of infertility in couples is due to male factors alone [5, 6]. The sixth edition of WHO is in discussion as some of the directions of changes would be: semen analysis
