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. 2021 Feb;53(1):e13861.
doi: 10.1111/and.13861. Epub 2020 Oct 30.

Normal sperm parameters per se do not reliably account for fertility: A case-control study in the real-life setting

Luca Boeri  1   2 , Federico Belladelli  1   3 , Paolo Capogrosso  1   4 , Walter Cazzaniga  1   3 , Luigi Candela  1   3 , Edoardo Pozzi  1   3 , Luca Valsecchi  5 , Enrico Papaleo  5   6 , Paola Viganò  5   6 , Costantino Abbate  1 , Filippo Pederzoli  1   3 , Massimo Alfano  1 , Francesco Montorsi  1   3 , Andrea Salonia  1   3
Affiliations

Normal sperm parameters per se do not reliably account for fertility: A case-control study in the real-life setting

Luca Boeri et al. Andrologia. 2021 Feb.

Abstract

A proportion of men are infertile despite having normal medical history/physical examination and normal semen analysis. We aimed to assess whether normal sperm parameters per se account for male factor fertility. 1,957 infertile men were compared with 103 age-comparable fertile controls. Semen analysis was based on 2010 World Health Organization reference criteria. Of all, 12.1% of infertile men and 40.8% of fertile men presented with normal sperm parameters. Among fertile men, 36.9% had isolated sperm abnormalities and 22.3% men showed two or more concomitant sperm abnormalities. Serum total testosterone was higher in infertile men with normal sperm parameters compared to those with ≥2 sperm abnormalities or azoospermia, but similar to those with isolated sperm abnormalities (p ≤ .001). Circulating hormones were similar among sperm parameters groups in fertile men. At multivariable analyses, testicular volume (OR 1.12, p ≤ .001) and FSH (OR 0.8, p ≤ .001) were associated with normal sperm parameters. Overall, the longer the infertility period, the greater the number of sperm parameters abnormalities (p < .01). In conclusion, we found that 12% of infertile men and only 41% of fertile men present with normal sperm parameters. Normal sperm parameters per se do not reliably account for fertility in the real-life setting.

Keywords: male factor infertility; risk factors; semen parameters; testicular volume.

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