Can we disregard geography when using the World Health Organization semen analysis reference ranges?

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Can we disregard geography when using the World Health Organization semen analysis reference ranges?
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Go to the profile of Pandiyan  Natarajan
4 months ago

Why WHO manual is a good starting point and NOT a Global Reference Range.

WHO manuals were a good starting point in avoiding the pell mell that existed in the Semenalysis landscape before 1980. However, unfortunately the first 4 volumes were based on consensus which is a poor way of doing science. The 4th manual emphasized the need for regionalization of Reference values. One of our Ph.D students undertook such a study and we found the Reference values were much lower in South Indian men whose wives were then currently pregnant.(1)

The 5th and 6th WHO manuals were significantly better than the previous volumes as they were based on population wide data. They also had limitations as they were based on a single semen analysis report. Semen analysis is notoriously variable form time to time in the same individual. The studied populations is also not representative of the different sections of the people. 

Therefore I would like to emphasize that the WHO manual is a good starting point and NOT a Global Reference Range.  Regional  Reference data are crucial for proper interpretation of Semen Analysis.

1. A perspective on sperm DNA fragmentation.                                                                                                   Natarajan Pandiyan, Radha Pandiyan, D. Ramesh Raja.  https://tau.amegroups.com/article/view/14381/14525

Professor Dr Pandiyan Natarajan,

Chief Consultant in Andrology and Reproductive Sciences,

Apollo 24/7, NOVA IVF FERTILITY,

 Chettinad Super Speciality Hospital (Retired)

Professor Emeritus, The Tamil Nadu Dr MGR Medical University.