The World Journal of Men's Health (Apr 2022)
Sperm Vitality and Necrozoospermia: Diagnosis, Management, and Results of a Global Survey of Clinical Practice
- Ashok Agarwal,
- Rakesh K. Sharma,
- Sajal Gupta,
- Florence Boitrelle,
- Renata Finelli,
- Neel Parekh,
- Damayanthi Durairajanayagam,
- Ramadan Saleh,
- Mohamed Arafa,
- Chak Lam Cho,
- Ala’a Farkouh,
- Amarnath Rambhatla,
- Ralf Henkel,
- Paraskevi Vogiatzi,
- Nicholas Tadros,
- Parviz Kavoussi,
- Edmund Ko,
- Kristian Leisegang,
- Hussein Kandil,
- Ayad Palani,
- Gianmaria Salvio,
- Taymour Mostafa,
- Osvaldo Rajmil,
- Saleem Ali Banihani,
- Samantha Schon,
- Tan V. Le,
- Ponco Birowo,
- Gökhan Çeker,
- Juan Alvarez,
- Juan Manuel Corral Molina,
- Christopher C.K. Ho,
- Aldo E. Calogero,
- Kareim Khalafalla,
- Mesut Berkan Duran,
- Shinnosuke Kuroda,
- Giovanni M. Colpi,
- Armand Zini,
- Christina Anagnostopoulou,
- Edoardo Pescatori,
- Eric Chung,
- Ettore Caroppo,
- Fotios Dimitriadis,
- Germar-Michael Pinggera,
- Gian Maria Busetto,
- Giancarlo Balercia,
- Haitham Elbardisi,
- Hisanori Taniguchi,
- Hyun Jun Park,
- Israel Maldonado Rosas,
- Jean de la Rosette,
- Jonathan Ramsay,
- Kasonde Bowa,
- Mara Simopoulou,
- Marcelo Gabriel Rodriguez,
- Marjan Sabbaghian,
- Marlon Martinez,
- Mohamed Ali Sadighi Gilani,
- Mohamed S. Al-Marhoon,
- Raghavender Kosgi,
- Rossella Cannarella,
- Sava Micic,
- Shinichiro Fukuhara,
- Sijo Parekattil,
- Sunil Jindal,
- Taha Abo-Almagd Abdel-Meguid,
- Yoshiharu Morimoto,
- Rupin Shah
Affiliations
- Ashok Agarwal
- ORCiD
- Cleveland Clinic, Cleveland, OH, USA
- Rakesh K. Sharma
- ORCiD
- Cleveland Clinic, Cleveland, OH, USA
- Sajal Gupta
- ORCiD
- Cleveland Clinic, Cleveland, OH, USA
- Florence Boitrelle
- ORCiD
- Poissy Hospital, Poissy, France
- Renata Finelli
- ORCiD
- Cleveland Clinic, Cleveland, OH, USA
- Neel Parekh
- ORCiD
- Cleveland Clinic, Cleveland, OH, USA
- Damayanthi Durairajanayagam
- ORCiD
- Sungai Buloh Campus, Selangor, Malaysia
- Ramadan Saleh
- ORCiD
- Sohag University, Sohag, Egypt
- Mohamed Arafa
- ORCiD
- Cleveland Clinic, Cleveland, OH, USA
- Chak Lam Cho
- ORCiD
- SH Ho Urology Center, Department of Surgery, Chinese University of Hong Kong, Hong Kong
- Ala’a Farkouh
- ORCiD
- Cleveland Clinic, Cleveland, OH, USA
- Amarnath Rambhatla
- ORCiD
- Department of Urology, Vattikuti Urology Institute, Henry Ford Health System, Detroit, MI, USA
- Ralf Henkel
- ORCiD
- Cleveland Clinic, Cleveland, OH, USA
- Paraskevi Vogiatzi
- ORCiD
- Andromed Health & Reproduction, Fertility Diagnostics Laboratory, Maroussi, Greece
- Nicholas Tadros
- ORCiD
- Division of Urology, Southern Illinois University School of Medicine, Springfield, IL, USA
- Parviz Kavoussi
- ORCiD
- Austin Fertility and Reproductive Medicine/Westlake IVF, Department of Urology, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
- Edmund Ko
- ORCiD
- Department of Urology, Loma Linda University Health, Loma Linda, CA, USA
- Kristian Leisegang
- ORCiD
- Department of Physiology, School of Natural Medicine, Faculty of Community and Health Sciences, University of the Western Cape, Bellville, South Africa
- Hussein Kandil
- ORCiD
- Fakih IVF Fertility Center, Abu Dhabi, UAE
- Ayad Palani
- ORCiD
- Department of Biochemistry, College of Medicine, University of Garmian, Kalar, Iraq
- Gianmaria Salvio
- ORCiD
- Department of Endocrinology and Metabolic Diseases, Polytechnic University of Marche, Ancona, Italy
- Taymour Mostafa
- ORCiD
- Department of Andrology, Sexology and STIs, Faculty of Medicina, Cairo University, Cairo, Egypt
- Osvaldo Rajmil
- ORCiD
- Department of Andrology, Fundacio Puigvert, Barcelona, Spain
- Saleem Ali Banihani
- ORCiD
- Department of Medical Laboratory Sciences, Faculty of Applied Medical Sciences, Jordan University of Science and Technology, Irbid, Jordan
- Samantha Schon
- ORCiD
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, MI, USA
- Tan V. Le
- ORCiD
- Department of Andrology and Urology, Pham Ngoc Thach University of Medicine, Ho Chi Minh City, Viet Nam
- Ponco Birowo
- ORCiD
- Department of Urology, Cipto Mangunkusumo General Hospital, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
- Gökhan Çeker
- ORCiD
- Samsun Vezirköprü State Hospital, Samsun, Turkey
- Juan Alvarez
- ORCiD
- Centro ANDROGEN, La Coruña, Spain
- Juan Manuel Corral Molina
- ORCiD
- Servicio de Urología, Hospital Clínico de Barcelona. Barcelona, Spain
- Christopher C.K. Ho
- ORCiD
- Department of Surgery, School of Medicine, Faculty of Health and Medical Sciences, Taylor’s University, Subang Jaya, Malaysia
- Aldo E. Calogero
- ORCiD
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
- Kareim Khalafalla
- ORCiD
- Department of Urology, Hamad Medical Corporation, Doha, Qatar
- Mesut Berkan Duran
- ORCiD
- Department of Urology, Samsun Training and Research Hospital, Samsun, Turkey
- Shinnosuke Kuroda
- ORCiD
- Cleveland Clinic, Cleveland, OH, USA
- Giovanni M. Colpi
- ORCiD
- Andrology and IVF Unit, Procrea Institute, Lugano, Switzerland
- Armand Zini
- ORCiD
- Department of Surgery, McGill University, Montreal, QC, Canada
- Christina Anagnostopoulou
- ORCiD
- IVF Clinic “Akeso-Embryo ART”, Athens, Greece
- Edoardo Pescatori
- ORCiD
- Andrology and Reproductive Medicine Unit, Gynepro Medical, Bologna, Italy
- Eric Chung
- ORCiD
- Department of Urology, Princess Alexandra Hospital, University of Queensland, Brisbane, QLD, Australia
- Ettore Caroppo
- ORCiD
- Reproductive and IVF Unit, Andrology Outpatients Clinic, ASL Bari, Conversano (Ba), Italy
- Fotios Dimitriadis
- ORCiD
- 1st Urology Department, School of Medicine, Aristotle University, Thessaloniki, Greece
- Germar-Michael Pinggera
- ORCiD
- Department of Urology, Innsbruck Medical University, Innsbruck, Austria
- Gian Maria Busetto
- ORCiD
- Department of Urology and Renal Transplantation, University of Foggia, Ospedali Riuniti of Foggia, Foggia, Italy
- Giancarlo Balercia
- ORCiD
- Department of Endocrinology and Metabolic Diseases, Polytechnic University of Marche, Ancona, Italy
- Haitham Elbardisi
- ORCiD
- Department of Urology, Hamad Medical Corporation, Doha, Qatar
- Hisanori Taniguchi
- ORCiD
- Department of Urology and Andrology, Kansai Medical University, Hirakata, Osaka, Japan
- Hyun Jun Park
- ORCiD
- Department of Urology, Pusan National University School of Medicine, Busan, Korea
- Israel Maldonado Rosas
- ORCiD
- Citmer Reproductive Medicine, IVF LAB, Mexico City, Mexico
- Jean de la Rosette
- ORCiD
- Department of Urology, Medipol Mega University Hospital, Istanbul, Turkey
- Jonathan Ramsay
- ORCiD
- Department of Andrology, Hammersmith Hospital, London, UK
- Kasonde Bowa
- ORCiD
- Department of Urology, Michael Chilufya Sata Copperbelt University School of Medicine, Ndola, Zambia
- Mara Simopoulou
- ORCiD
- Department of Experimental Physiology, School of Health Sciences, Faculty of Medicine, National and Kapodistrian University of Athens, Athens, Greece
- Marcelo Gabriel Rodriguez
- ORCiD
- Departamento Docencia e Investigación, Hospital Militar Campo de Mayo, Universidad Barcelo, Buenos Aires, Argentina
- Marjan Sabbaghian
- ORCiD
- Department of Andrology, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
- Marlon Martinez
- ORCiD
- Section of Urology, University of Santo Tomas Hospital, Manila, Philippines
- Mohamed Ali Sadighi Gilani
- ORCiD
- Department of Andrology, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
- Mohamed S. Al-Marhoon
- ORCiD
- Department of Surgery, Urology Division, Sultan Qaboos University, Muscat, Oman
- Raghavender Kosgi
- ORCiD
- Department of Urology and Andrology, AIG Hospitals, Gachibowli, Hyderabad, India
- Rossella Cannarella
- ORCiD
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
- Sava Micic
- ORCiD
- Department of Andrology, Uromedica Polyclinic, Belgrade, Serbia
- Shinichiro Fukuhara
- ORCiD
- Department of Urology, Graduate School of Medicine, Osaka University, Osaka, Japan
- Sijo Parekattil
- ORCiD
- Avant Concierge Urology & University of Central Florida, Winter Garden, FL, USA
- Sunil Jindal
- ORCiD
- Department of Andrology and Reproductive Medicine, Jindal Hospital, Meerut, India
- Taha Abo-Almagd Abdel-Meguid
- ORCiD
- Department of Urology, Faculty of Medicine, Minia University, Minia, Egypt
- Yoshiharu Morimoto
- ORCiD
- HORAC Grand Front Osaka Clinic, Osaka, Japan
- Rupin Shah
- ORCiD
- Division of Andrology, Department of Urology, Lilavati Hospital and Research Centre, Mumbai, India
- DOI
- https://doi.org/10.5534/wjmh.210149
- Journal volume & issue
-
Vol. 40,
no. 2
pp. 228 – 242
Abstract
Sperm vitality testing is a basic semen examination that has been described in the World Health Organization (WHO) Laboratory Manual for the Examination and Processing of Human Semen from its primary edition, 40 years ago. Several methods can be used to test sperm vitality, such as the eosin-nigrosin (E-N) stain or the hypoosmotic swelling (HOS) test. In the 6th (2021) edition of the WHO Laboratory Manual, sperm vitality assessment is mainly recommended if the total motility is less than 40%. Hence, a motile spermatozoon is considered alive, however, in certain conditions an immotile spermatozoon can also be alive. Therefore, the differentiation between asthenozoospermia (pathological decrease in sperm motility) and necrozoospermia (pathological decrease in sperm vitality) is important in directing further investigation and management of infertile patients. The causes leading to necrozoospermia are diverse and can either be local or general, testicular or extra-testicular. The andrological management of necrozoospermia depends on its etiology. However, there is no standardized treatment available presently and practice varies among clinicians. In this study, we report the results of a global survey to understand current practices regarding the physician order of sperm vitality tests as well as the management practices for necrozoospermia. Laboratory and clinical scenarios are presented to guide the reader in the management of necrozoospermia with the overall objective of establishing a benchmark ranging from the diagnosis of necrozoospermia by sperm vitality testing to its clinical management.
Keywords
