Evaluation of the Spermatozoa and Seminal Plasma of the Infertile Male
WITH present-day tests, the reasons for male infertility may be easily discernible, obscure, or impossible of detection. While it is true that azoospermia, oligospermia, asthenospermia, and the presence of a large number of abnormal forms are readily recognized causes of infertility, other reasons are less obvious. Biochemical or cytochemical technics have demonstrated other abnormalities of semen, the clinical implications of which are not completely understood, and corrective measures are not generally available. However, information is being accumulated, and with continuing research there is reason to hope that the problem will be solved.
The clinical study of the infertile couple as a unit was recently reviewed by Ward.1 The present discussion is concerned solely with laboratory studies of spermatozoa and seminal plasma, the functions of the constituents of semen which are known, and how abnormalities of unit parts of whole semen may contribute to male infertility. For the sake of completeness, mention is made of the routine semen analysis; however, the primary purpose of this paper is to bring into focus other aspects of semen physiology which, when found to be abnormal, should certainly be considered as possible reasons for infertility.
Routine Semen Analysis
The semen analysis as it is customarily performed consists of the following steps: (l) measurement of volume, (2) determination of pH, (3) wet smear motility evaluation, (4) sperm count, (5) stained smear morphologic study, (6) a viability test 4 or more hours after the initial motility appraisal.2–4
Such an analysis will occasionally suffice to reveal the cause . . .