PREDICTIVE LIMITS OF WHO SEMEN ANALYSIS FOR REAL FERTILITY OUTCOMES: A CRITICAL APPRAISAL OF DIAGNOSTIC UTILITY IN MALE REPRODUCTIVE MEDICINE
Abstract
The World Health Organization (WHO) semen analysis
remains the cornerstone of male fertility assessment,
providing standardized reference values for sperm
concentration, motility, and morphology. However, its
ability to predict real-world fertility outcomes remains
contest. This paper critically evaluates the predictive
capacity and limitations of WHO semen analysis in
relation to natural conception, assisted reproductive
outcomes, and live birth rates. This narrative review
synthesizes evidence from epidemiological studies, cohort
analyses, meta-analyses, and guideline reports
examining correlations between semen parameters and
reproductive outcomes. Emphasis is placed on predictive
validity, diagnostic thresholds, and clinical applicability.
While abnormal semen parameters are associated with
reduced fertility, normal WHO-defined values do not
reliably predict fertility potential. Significant overlap
exists between fertile and infertile populations. Semen
analysis demonstrates limited sensitivity and specificity
for predicting natural conception and ART success.
Functional sperm defects, including DNA fragmentation
and oxidative stress, are not captured by routine analysis.
WHO semen analysis provides valuable baseline
information but has limited predictive power for real
fertility outcomes. Its utility lies in screening rather than
prognostication. Integration with functional biomarkers
and clinical context is necessary to improve diagnostic
accuracy and patient management.
This article is available as a PDF download
Published in UNIHEZ JOURNAL OF HEALTH SCIENCES, ENGINEERING, INFORMATION AND COMMUNICATION TECHNOLOGY
ISSN: 979-41323
This article appears in our peer-reviewed academic journal
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