Human Reproduction, Vol. 15, No. 7, 1562-1567,
July 2000
© 2000 European Society of Human Reproduction and Embryology
Computer-assisted semen analysis parameters as predictors for fertility of men from the general population
1 Department of Growth and Reproduction, Copenhagen University Hospital, DK-2100 Copenhagen, 2 Department of Biostatistics, University of Copenhagen, Panum Institute, DK-2200 Copenhagen, 3 Department of Occupational Medicine, Aarhus University Hospital, DK-8000 Aarhus, Denmark and 4 Department of Urology, Malmö University Hospital, Malmö, Sweden
The predictive value of sperm motility parameters obtained by computer-assisted semen analysis (CASA) was evaluated for the fertility of men from general population. In a prospective study with couples stopping use of contraception in order to try to conceive, CASA was performed on semen samples from 358 men. A recently developed CASA system, Copenhagen Rigshospitalet Image house sperm Motility Analysis System (CRISMAS) was used for assessment of motility parameters. This system has an editing function which allows correction of tracks made by the computer. Probably due to this function, the concentration assessment made by CRISMAS was very close to that made by the technician (median difference <5%) in all concentration ranges. Correlation between CASA parameters and fertility of normal couples (measured as probability of achieving pregancy) was examined by the Cox regression model. In univariate models ln(sperm concentration) [ß = 0.331, risk ratio (RR) = 1.392, P = 0.0001], ln(total sperm count) (ß = 0.252, RR = 1.286, P = 0.0007) and percentage motile spermatozoa (ß = 0.014, RR = 1.014, P = 0.0004) were most significant predictors for fertility. In a multivariate analysis ln(sperm concentration) (ß = 0.268, RR = 1.307, P = 0.0016) and percentage motile spermatozoa (ß = 0.010, RR = 1.010, P = 0.011) but even more significantly the combined parameter, ln(concentration of motile spermatozoa) (ß = 0.329, RR = 1.389, P = 0.0001), were the only parameters of predictive value for fertility of men in the general population. In conclusion, these parameters obtained by CASA measurements can be used for prediction of fertility potential in normal men. This appears to be the first study showing the value of CASA in prediction of fertility in the general male population.
Key words: computer-assisted semen analysis/male fertility/semen quality/sperm concentration
5 To whom correspondence should be addressed at: University Department of Urology, Malmö University Hospital, SE 205 02 Malmö, Sweden. E-mail: aleksander.giwercman{at}kir.mas.lu.se
* The Danish First Pregnancy Planner Study is a collaborative follow-up study on environmental and biological determinants of fertility. The project is co-ordinated by the Steno Institute of Public Health, University of Århus and is undertaken in Collaboration with the Department of Growth and Reproduction, National University Hospital in Copenhagen. The team includes Jens Peter E.Bonde, Niels Henrik I.Hjollund, Tina Kold Jensen, Tine Brink Henriksen, Henrik A.Kolstad, Erik Ernst, Anne-Marie Andersson, Aleksander Giwercman, Niels Erik Skakkebæk and Jørn Olsen.
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