Weakness of routine semen analysis identified

Routine semen analysis does not absolutely predict the quality of sperm chromatin, which may help to explain why it often fails to predict reproductive outcomes in infertile couples, results of a Canadian study suggest.

The study's authors, from McGill University in Montreal, suggested that sperm chromatin quality evaluation could provide additional information that can facilitate decision making in male fertility management.

"Routine semen analysis using World Health Organization reference values is the most commonly ordered evaluation in this population, and decisions on patient management rely heavily on its results. Unfortunately, other than at extreme values, semen analyses fail to predict reproductive outcomes," said first author Peter T. Chan, MD, who presented the group's data at yesterday's AUA annual meeting.

Dr. Chan and colleagues carried out their evaluation using four distinct patient groups. A total of 21 men in the study presented with idiopathic infertility, while 19 others were healthy community volunteers. In addition, the study included 12 men with advanced testicular cancer (>2 months post-orchiectomy) and 11 others with Hodgkin's lymphoma.

After patients' semen parameters were analyzed according to WHO criteria, their sperm chromatin quality was assessed with four complementary flow cytometry-based tests: acridine orange (AO) assay, terminal deoxynucleotidyl transferase-mediated dUTP nick-end labeling (TUNEL), chromomycin A3, and monobromobimane thiol labeling (mBBr) assay.

The assays measure sperm chromatin quality in different ways, but their results were closely coordinated in the McGill study. TUNEL assay results, for example, paralleled those from AO (pp

On the other hand, there was no correlation found within any of the four patient groups among motile sperm density, normal morphology sperm density, and the four sperm chromatin assays.

Tune into www.urologytimes.com/radio for an excerpt of the interview with Dr. Chan.