Clinical Assessment of Human Sperm Function

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Abstract
It is an unfortunate fact that the techniques currently used by andrologists to diagnose male infertility are so insensitive that the conditions they detect are, in general, beyond treatment. There is an urgent need to develop more sensitive techniques of diagnosis, capable of identifying subfertile conditions more amenable to the few forms of treatment at our disposal. With the possible exception of varicocoele ligation, the shape that such treatment takes frequently involves utilising the potential of the spermatozoa that are present in the ejaculate, through artificial insemination or in vitro fertilisation, rather than improving the basic quality of sperm production. If we are to take advantage of such treatments, the basis on which male fertility is diagnosed should be extended from its current descriptive base to consider the adequacy of sperm function. Indeed, an accurate description of male fertility will only come about when we have clearly defined the biological components of sperm function and have developed suitable assay systems for their objective assessment.