As stated in the Manual of Andrology of the Spanish Society of Fertility: "although the results of semen analysis can give us information about problems in the function of the male genital organs, they do not allow us to determine with certainty whether an individual is fertile or not". So, if the semen analysis is normal, should other tests be performed? In the initial assessment of a couple with reproductive dysfunction, no. The seminogram is more a tool to guide treatment than to reach a diagnosis. In addition, it is obviously advisable to study and assess the woman as well. The woman's age is the parameter that best predicts the result of an assisted reproduction treatment. We can continue to study a male with normozoospermia but if, due to the age of his partner, it is advisable to carry out an in vitro fertilization, we will be wasting precious time carrying out studies that will not finally change our therapeutic indication.
It is true that there are other complementary tests that can help to study the semen in greater depth, such as the study of the double chain fragmentation of the spermatozoa's DNA. Our team analyzed the results of the cycles of 12 couples with implantation failures or repeated miscarriages, in which the male presented this alteration. We used the Fertile chamber which, through microfluidic dynamics, we hypothesized, allowed us to select those spermatozoa that had less fragmentation. We obtained a clinical pregnancy rate of 84.6%. This type of test promises to advance in the evaluation of the male but even so, we insist, they are not indicated in the initial study of a couple with reproductive dysfunction. Even if you have normozoospermia.