As many will be aware, the new 6th edition of the WHO laboratory manual for the examination and processing of human semen has just been released. This webpage link takes you to a page with the launch webinar and a free download of the entire manual.
The methods in this manual are set down as a global consensus. One aim is to try and ensure wherever in the world semen is examined or processed we can compare and interpret the results – so when you look at a work from somewhere else, you can have confidence in drawing conclusions for your practice.
For ARCS members Chapter 2: Basic Examination will be the most important read – with slight alterations from previous editions to include:
- scoring four motility categories;
- scoring morphology in its multiple categories, and importantly using these for quality control (e.g. do operators agree on number of midpiece defects, not an overall ‘normal’ percentage of everything combined).
We suggest everyone has a careful read of this section – giving consideration to the changes required in reporting semen analysis results. ARCS is also organising guidance around this over the coming months
A WHO requirement for these is they should be able to be performed in any lab anywhere in the world with limited resources. Many will be keen to read this alongside Chapter 8: Appendices which contains guidance on interpretation of results, and the new table (8.2) of semen examination results from men in couples starting a pregnancy within one year of unprotected sexual intercourse leading to a natural conception (what conventionally we have called ‘Normal’).
However, take note of the following:
“This manual is not a guideline for clinical decisions as to the choice of treatment modalities for male factor infertility. Still, it is the responsibility of each laboratory to provide information that can facilitate the interpretation of the results. The most sought-after information is a divide between fertility and infertility…caution is needed to avoid over-interpretation…”
We suggest everyone has a careful read of this section – giving consideration to the changes required in reporting semen analysis results. ARCS is also organising guidance around this over the coming months.
The manual then has a number of further chapters including: Chapter 3: Extended Examination (with examination useful in certain circumstances); Chapter 4: Advanced Examination (for those mainly still sitting within a research environment); and less recognised ones covering sperm preparation and cryopreservation. Chapter 7: Quality assurance and quality control is also going to be a key read for all members.
If you have any questions or practical queries, why not start a new thread on the ARCS forum and see if the ARCS community can help you?