Sperm Vitality

The importance of sperm vitality testing in the assessment of the infertile couple has been recently confirmed by its inclusion in the sixth edition of the World Health Organization (WHO) Laboratory Manual for the Examination and Processing of Human Semen in the basic examination chapter. In detail, sperm vitality testing could be routinely conducted in all cases of sperm motility less than 40% to distinguish between live (normal sperm vitality) and dead immobile spermatozoa (sperm vitality <25–30%), the latter condition also known as necrozoospermia. The identification of necrozoospermia cases is of utmost importance because reversible causes of necrozoospermia exist. In addition, couples in which the male partner suffers from necrozoospermia could undergo assisted reproductive technology (ART) or non-ART management, the latter including repeated ejaculation, antioxidants, and varicocele repair. If ART is chosen, further examinations, including sperm DNA fragmentation (SDF) testing, can be offered for prognostic purposes and to decide among different therapeutic strategies (e.g., sperms from ejaculate or testicular sperms to use for intracytoplasmic sperm injection, ICSI), and different selection techniques to identify if viable sperms are available.