SEMINAL FLUID ANALYSIS AND SPERM FUNCTION TESTING

Infertility is a common problem affecting at least one couple in six in Europe.(48, 114, 117) Epidemiologic surveys of new couples attending infertility clinics in the United Kingdom have suggested that about one in four present with clear evidence of defective sperm function,48 abnormal semen quality being the most common single diagnosis arrived at in many clinics.(100) Moreover, evidence suggests that semen quality in the population is deteriorating,(27) perhaps as a result of environmental factors acting early in fetal development.(42, 107) These observations serve to emphasize the importance of improving our understanding of the eel biology of the human spermatozoon and defining, at a molecular level, the defects responsible for the loss of fertilizing potential. It is only when this information is available that a rational approach to the design of appropriate therapies can be undertaken. This knowledge gradually is being acquired, and in its wake we are seeing the progressive refinement of the techniques used for the diagnosis of male infertility. These developments are considered in this review, from the traditional descriptive semen profile to the functional bioassays and biochemical criteria that characterize the state-of-the-art diagnostic andrology laboratory.