Infertile men with semen parameters above WHO reference limits at first assessment may deserve a second semen analysis: Challenging the guidelines in the real-life scenario

Luca Boeri, Edoardo Pozzi, Paolo Capogrosso, Giuseppe Fallara, Federico Belladelli, Luigi Candela, Nicolò Schifano, Christian Corsini, Walter Cazzaniga, Daniele Cignoli, Eugenio Ventimiglia, Marina Pontillo, Massimo Alfano, Francesco Montorsi and Andrea Salonia

PLOS ONE, 2023, vol. 18, issue 1, 1-12

Abstract: Objectives: To investigate which infertile men with semen parameters above WHO reference limits at first semen analysis deserve a second semen test. Materials and methods: Data from 1358 consecutive infertile men were analysed. Patients underwent two consecutive semen analyses at the same laboratory. Descriptive statistics and logistic regression models tested the association between clinical variables and semen parameters. A new predicting model was identified through logistic regression analysis exploring potential predictors of semen parameters below WHO reference limits after a previously normal one. Diagnostic accuracy of the new model was compared with AUA/ASRM and EAU guidelines. Decision curve analyses (DCA) tested their clinical benefit. Results: Of 1358, 212 (15.6%) infertile men had semen parameters above WHO reference limits at first analysis. Of 212, 87 (41.0%) had a second semen analysis with results above WHO reference limits. Men with sperm parameters below reference limits at second analysis had higher FSH values, but lower testicular volume (TV) (all p

Date: 2023
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Persistent link: https://EconPapers.repec.org/RePEc:plo:pone00:0280519

DOI: 10.1371/journal.pone.0280519

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