Infertility is gaining more awareness the world over, since such a large percentage globally is affected by inability to conceive. According to WHO (World Health Organisation), the ratio is about 1:6 people and, in a number of cases, it is the male partner who is responsible.
The World Health Organisation is the internationally recognised agency responsible for public health. In its recent Laboratory Manual for the examination and processing of human sperm, the subject of infertility has been highlighted, drawing attention to this condition which is affecting a large number of people. To counteract it, there is an urgent need to supply high-quality fertility care, including male infertility testing, to those in need, which is easily accessible and affordable.
In the latest 6th edition of the WHO Laboratory Manual, published in July 2021, some of the references or norms of evaluations have been revised. It has gone into detail with better quality micrographs showing sperm from unprocessed semen samples which are now considered normal, borderline or abnormal, with explanations and descriptions of why each spermatozoon is classified as such.
Different forms of abnormalities with sperm chromosomes and mutations in genes have been mentioned, along with the important factors of how sperm DNA fragmentation, reactive oxygen species and seminal oxidative stress affect fertility.
Now, just a semen analysis will not be able to identify fertility, since the process of fertilisation depends on a multiple of factors. Along with the established procedures, new techniques have come into practice, including the SCSA (sperm chromatin structure assay) test, sperm chromatin dispersion test, use of acridine orange flow cytometry, TUNEL assay, COMET and others for testing of Sperm DNA Fragmentation.
The progress made in understanding male reproductive health has been enormous, but there is still much more to be done. New methods for sperm preparation for clinical use or specialised function assays as well as sperm cryopreservation need to be further researched and standardised.
The new WHO Manual has taken this into consideration and offered a foundation of efficient protocols for semen processing for laboratories. This allows fertility specialists to better decipher the reference values for semen parameters. In turn, this opens the gate to providing more opportunities for better counseling and remedial measures. However, the Manual is just the reference aid for specialists in the field and is not meant to replace decision-making on aspects of the patient’s care. Clinical management by a fertility specialist still needs to be conducted and evaluated.
At Andrology Center, we play a significant part in this new approach to infertility by carrying out the globally acknowledged SCSA® test for DFI (sperm DNA fragmentation), specifically mentioned in the WHO Manual. This is in addition to the basic semen analysis. Due to the top technology and sophisticated equipment we use, our results are guaranteed to be accurate. We provide clinically relevant, standardised reports which are a great help to fertility specialists in deciding on the best treatment for the couple.
We are proud to state that we are the only laboratory in India authorised to carry out the genuine SCSA® (sperm chromatin structure assay) test.