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Reproducibility and Reliability of Semen Analyses in Youths at Risk for Infertility

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Published:25th Mar 2020
Purpose: There is little normative data on semen analyses in youths at risk for, but who do not present with, infertility. Standard practice amongst infertility specialists includes evaluation of two separate semen samples given the degree of within-subject variability. We hypothesize that males transitioning from pediatric to adult care who are at risk for infertility would similarly have this variability. Materials and Methods: A retrospective review of patients with a history of cryptorchidism or varicocele who submitted two semen samples for evaluation of fertility potential was conducted. The within-subject coefficient of variation (CVw) and intraclass correlation coefficient (ICC) were calculated for each semen parameter to evaluate reproducibility and reliability, respectively. Results: A total of 79 subjects were studied. Mean age � SD was 18.8 � 1.2 years (range 17.8 � 24.7). The CVw was high for each semen parameter, ranging from 36% for volume and motility to 82% for total motile count (TMC). ICC for a single SA ranged from 0.55 for motility to 0.88 for total count. ICC for TMC was 0.78 [95% CI, 0.67 � 0.85], consistent with substantial reliability. Conclusions: Although within-patient variability of individual SA parameters was found, overall there was substantial agreement between consecutive semen analyses in this population at risk for infertility -- particularly regarding TMC, which is the most important determinant of fertility from a SA. Therefore, it is possible to appropriately classify some young men based on the result of a single measurement as they transition from pediatric to adult care.

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