Clinical Implications of the WHO 6th Edition on Human Semen Analysis

The first test to be examined in men who present with an infertility problem is the basic semen analysis. The sixth edition of the World Health Organization manual of human semen analysis was published in 2021 with some innovations. It is proposed to abandon the concept of reference thresholds and replace it with decision limits. The guideline stated that the fifth percentiles given as reference values cannot be considered separately from the clinical aspects of the patient and should be used only as a guide in the clinical evaluation of the infertile man. The concept of “norm” was erased, and terms like teratozoospermia and necrozoospermia were removed. Extended semen tests have been developed to help predict the fertility potential of the male partner. Although not routinely used, they are respectively indicated in certain clinical scenarios. Examples of these tests include sperm DNA fragmentation.