The effect of suboptimal semen parameters on male partner's ability to conceive. Is he really subfertile because the test says so?

Abstract

Context: In many developing countries, subfertility treatment is not covered by government-funded institutions. It is observed that healthcare providers incriminate male factor for subfertility even when only a slight deviation from presumed normal criteria is observed. Aim: This study aims to provide scientific evidence that pregnancies are possible at semen parameters that are below the generally accepted lower limits of normal. Setting and Design: This was a retrospective cohort study conducted from January 2014 to December 2018. Materials and Methods: During the study period, couples who conceived without any treatment of male partner were included. The World Health Organization (WHO) reference values for semen analysis were utilized to assess the reports. The primary outcome measure was conception despite abnormal semen parameters. Statistical Analysis Used: Data were analyzed using the SPSS software program, version 15.0 (IBM, Armonk, USA). Results: Of the 332 couples included, 233 (70.1%) couples conceived despite suboptimal semen parameters, The most common criterion not satisfied was rapid linear motility –200 (85.8%), 87 (37.3%) men were oligozoospermic, 94 (40.3%) were asthenozoospermic, and 21 (9%) were teratozoospermic. The abnormalities were more common in men having primary subfertility (71.7% vs. 28.3%, P = 0.002). The abnormalities were most common in the age group 40–44 years (n = 91, 39.1%) and those who were overweight (n = 110, 47%). Conclusions: A consensus for defining poor semen criteria is the need of the hour so that these males can be counseled satisfactorily. WHO criteria are a standard commonly employed, but they do not necessarily predict the fertility potential.

Keywords

• male subfertility
• semen parameters
• world health organization semen analysis criteria