Semen Analysis and Other Tests for Male Infertility

  • James W. Overstreet


Semen analysis includes the basic laboratory tests for initial assessment of the male partner of an infertile couple. The basic semen evaluation provides the clinician not only with information on testicular function but also with evidence for patency of the reproductive tract and of the man’s ability to ejaculate. Despite the basic importance of these tests, neither the methods for semen evaluation nor the criteria for interpretation of results have been fully standardized. These problems are well illustrated by the current controversy over the suggested decline in sperm counts worldwide during the past 50 years.1–3 Scientific criticism has been based not only on the statistical methodology used in the original analysis but also on the realization that the methods for collection and analysis of semen have varied widely in the past five decades.3 Although much progress has been made recently in the standardization of semen evaluation procedures, the results of previous studies must be evaluated carefully. Nevertheless, when infertility is suspected, a semen evaluation should be obtained at the initiation of the clinical workup.


Sperm Motility Male Infertility Sperm Concentration Human Sperm Acrosome Reaction 
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  1. 1.
    Carlson E, Giwercman A, Keiding N, et al. Evidence for decreasing quality of semen during past 50 years. Br Med J 1992; 305: 609–613.CrossRefGoogle Scholar
  2. 2.
    Stone R. Environmental estrogens stir debate. Science 1994; 265: 308–310.PubMedCrossRefGoogle Scholar
  3. 3.
    Olsen GW, Bodner KM, Ramlow JM, et al. Have sperm counts been reduced 50 percent in 50 years? A statistical model revisited. Fertil Steril 1995; 63: 887–893.PubMedGoogle Scholar
  4. 4.
    Overstreet JW. Assessment of disorders of spermatogenesis. In: Lockey JW, Lemasters GK, Keye WR, eds. Reproduction: The New Frontier in Occupational and Environmental Health Research. New York: Alan Liss; 1984: 275–292.Google Scholar
  5. 5.
    Swartz D, Laplanche A, Jouannet P, et al. Within subject variabilities of human semen in regard to sperm count, volume, total number of spermatozoa and length of abstinence. J Reprod Fertil 1979; 57: 391–395.CrossRefGoogle Scholar
  6. 6.
    Oldereid NB, Gordeladze JO, Kirkhus B, et al. Human sperm characteristics during frequent ejaculation. J Reprod Fertil 1984; 71: 135–140.PubMedCrossRefGoogle Scholar
  7. 7.
    Levin RM, Latimore J, Wein AJ, et al. Correlation of sperm count with frequency of ejaculation. Fertil Steril 1990; 54: 906–909.Google Scholar
  8. 8.
    Baker HWG, Burger HG,, de Kretser DM et al. Factors affecting the variability of semen analysis results in infertile men. Int J Androl 1981; 4: 609–622.PubMedCrossRefGoogle Scholar
  9. 9.
    Tur-Kaspa I, Maor Y, Levran D, et al. How often should infertile men have intercourse to achieve conception? Fertil Steril 1994; 62: 370–375.PubMedGoogle Scholar
  10. 10.
    Zavos PM. Seminal parameters of ejaculates collected from oligospermic and normospermic patients via masturbation and at intercourse with the use of a Silastic seminal fluid collection device. Fertil Steril 1985; 44: 517–520.PubMedGoogle Scholar
  11. 11.
    Zavos PM, Kofinas GD, Sofikitis NV, et al. Differences in seminal parameters in specimens collected via intercourse and incomplete intercourse (coitus interruptus). Fertil Steril 1988; 61: 1174–1176.Google Scholar
  12. 12.
    Holt W, Watson P, Curry M, et al. Reproducibility of computer-aided semen analysis: comparison of five different systems used in a practical workshop. Fertil Steril 1994; 62: 1277–1282.PubMedGoogle Scholar
  13. 13.
    Overstreet JW. Semen liquefaction and viscosity problems. In: Tanagho EA, Lue TF, McClure RD, eds. Contemporary Management of Impotence and Infertility. Baltimore: Williams & Wilkins; 1988: 311–312.Google Scholar
  14. 14.
    Eliasson R. Analysis of semen. In: Behrman SJ, Kistner RW, eds. Progress in Infertility. 2nd ed. Boston: Little, Brown; 1975: 691–713.Google Scholar
  15. 15.
    World Health Organization. WHO Laboratory Manual for the Examination of Human Semen and Sperm-Cervical Mucus Interaction. 3rd ed. Cambridge, England: Press Syndicate of the University of Cambridge; 1992.Google Scholar
  16. 16.
    Zanaveld LJD, Jeyendran RS. Modern assessment of semen for diagnostic purposes. Sem Reprod Endocrinol 1988; 6: 324–337.Google Scholar
  17. 17.
    Freund M, Carol B. Factors affecting hemocytometer counts of sperm concentration in human semen. J Reprod Fertil 1964; 8: 149–155.PubMedCrossRefGoogle Scholar
  18. 18.
    Makler A. The improved ten-micrometer chamber for rapid sperm count and motility evaluation. Fertil Steril 1980; 33: 337–338.PubMedGoogle Scholar
  19. 19.
    Overstreet JW, Davis RO, Katz DF. Semen evaluation. Infertil Reprod Med Clin North Am 1992; 3: 329–340.Google Scholar
  20. 20.
    Peters AJ, Zaneveld LJD, Jeyendran RS. Quality assurance for sperm concentration using latex beads. Fertil Steril 1993; 60: 702–705.PubMedGoogle Scholar
  21. 21.
    Johnson JE, Boone WR, Blackhurst DW. Manual versus computer-automated semen analyses. Part 1. Comparison of counting chambers. Fertil Steril 1996; 65: 150–155.PubMedGoogle Scholar
  22. 22.
    Davis RO, Katz DF. Operational standards for CASA instruments. J Androl 1993; 14: 385–394.PubMedGoogle Scholar
  23. 23.
    Mortimer D. The male factor in infertility: semen analysis. Curr Probl Obstet Gynecol 1985; 8: 4–87.Google Scholar
  24. 24.
    Davis RO, Gravance CG. Consistency of sperm morphology classification methods. J Androl 1994; 15: 83–89.PubMedGoogle Scholar
  25. 25.
    Freund M. Standards for the rating of human sperm morphology: a cooperative study. Int J Fertil 1966; 11: 97–118.PubMedCrossRefGoogle Scholar
  26. 26.
    Eliasson R. Standards for investigation of human semen. Andrologia 1971; 3: 49–52.CrossRefGoogle Scholar
  27. 27.
    World Health Organization. WHO Manual for the Examination of Human Semen and Semen-Cervical Mucus Interaction. 2nd ed. Cambridge, England: Press Syndicate of the University of Cambridge; 1987.Google Scholar
  28. 28.
    Menkveld R, Stander FSH, Lotze TJ, et al. The evaluation of morphological characteristics of human spermatozoa according to stricter criteria. Hum Reprod 1990; 5: 586–592.PubMedGoogle Scholar
  29. 29.
    Davis RO, Gravance CG, Overstreet JW. A standardized test for visual analysis of human sperm morphology. Fertil Steril 1995; 63: 1058–1063.PubMedGoogle Scholar
  30. 30.
    Baccetti B, Bernieri G, Burrini AG, et al. Notulae Seminologicae. 5. Mathematical evaluation of interdependent submicroscopic sperm alterations. J Androl 1995; 16: 356–367.PubMedGoogle Scholar
  31. 31.
    Zamboni L. Sperm ultrastructural pathology as a cause of infertility. In: Asch RH, Balmaceda JP, Johnston I, eds. Gamete Physiology. Norwell, MA: Serono Symposia, USA; 1990: 119–126.Google Scholar
  32. 32.
    Naftulin BN, Samuels SJ, Hellstrom WJG, et al. Semen quality in varicocele patients is characterized by tapered sperm cells. Fertil Steril 1991; 56: 149–151.PubMedGoogle Scholar
  33. 33.
    Pelfrey RJ, Overstreet JW, Lewis EL. Abnormalities of sperm morphology in cases of persistent infertility after vasectomy reversal. Fertil Steril 1982; 28: 112–114.Google Scholar
  34. 34.
    Rosenbusch B, Strehler E, Sterzik K. Cytogenetics of human spermatozoa: correlations with sperm morphology and age of fertile men. Fertil Steril 1992; 58: 1071–1072.PubMedGoogle Scholar
  35. 35.
    Hill JA, Abbott AF, Politch JA. Sperm morphology and recurrent abortion. Fertil Steril 1994; 61: 776–778.PubMedGoogle Scholar
  36. 36.
    Wolff H, Anderson DJ. Immunohistologic characterization and quantitation of leukocyte subpopulations in human semen. Fertil Steril 1988; 49: 497–504.PubMedGoogle Scholar
  37. 37.
    Davis RO, Katz DF. Standardization and comparability of CASA instruments. J Androl 1992; 13: 81–86.PubMedGoogle Scholar
  38. 38.
    Garrett C, Baker HWG. A new fully automated system for the morphometric analysis of human sperm heads. Fertil Steril 1995; 63: 1306–1317.PubMedGoogle Scholar
  39. 39.
    MacLeod J, Gold RZ. Semen quality in 1000 men of known fertility and 800 cases of infertile marriage. Fertil Steril 1951; 2: 115–139.PubMedGoogle Scholar
  40. 40.
    Rehan NE, Sobrero AJ, Fertig JW. The semen of fertile men: statistical analysis of 1300 men. Fertil Steril 1975; 26: 492–502.PubMedGoogle Scholar
  41. 41.
    Zuckerman Z, Rodriguez-Rigau LJ, Smith KD, et al. Frequency distribution of sperm counts in fertile and infertile males. Fertil Steril 1977; 28: 1310–1313.Google Scholar
  42. 42.
    Dunphy BC, Neal LM, Cooke ID. The clinical value of conventional semen analysis. Fertil Steril 1989; 51: 324–329.PubMedGoogle Scholar
  43. 43.
    Glazener CMA, Kelly NJ, Weir MJA, et al. The diagnosis of male infertility. A prospective time-specific study of conception rates related to seminal analysis and postcoital sperm-mucus penetration and survival in otherwise unexplained infertility. Hum Reprod 1987; 2: 665–671.PubMedGoogle Scholar
  44. 44.
    Eimers JM, to Velde ER, Gerritse R, et al. The prediction of the chance to conceive in subfertile couples. Fertil Steril 1994; 61: 4452.Google Scholar
  45. 45.
    Dubin L, Amelar RD. Etiologic factors in 1294 consecutive cases of male infertility. Fertil Steril 1971; 22: 169.Google Scholar
  46. 46.
    Boyers S. Evaluation and treatment of disorders of the cervix. In: Keye WR, Chang RJ, Rebar RW, Soules MR, eds. Infertility Evaluation and Treatment. Philadelphia: W.B. Saunders; 1995: 195–229.Google Scholar
  47. 47.
    MacLeod J, Wang Y. Male fertility potential in terms of semen quality: a review of the past, a study of the present. Fertil Steril 1979; 21: 103–116.Google Scholar
  48. 48.
    Peng H-Q, Collins JA, Wilson EH, et al. Receiver-operating characteristics curves for semen analysis variables: methods for evaluation of diagnostic tests of male gamete function. Gamete Res 1987; 17: 229–236.PubMedCrossRefGoogle Scholar
  49. 49.
    Barratt CLR, Tomlinson MJ, Cooke ID. Prognostic significance of computerized motility analysis for in vivo fertility. Fertil Steril 1993; 60: 520–525.PubMedGoogle Scholar
  50. 50.
    Wallace EM, Aitken RJ, Wu FCW. Residual sperm function in oligozoospermia induced by testosterone enanthate administered as a potential steroid male contraceptive. Int J Androl 1992; 15: 416–424.PubMedCrossRefGoogle Scholar
  51. 51.
    Burris AS, Clark RV, Vantman DJ, et al. A low sperm concentration does not preclude fertility in men with isolated hypogonadotropic hypogonadism after gonadotropin therapy. Fertil Steril 1988; 50: 343–347.PubMedGoogle Scholar
  52. 52.
    Bostofte E, Bagger P, Michael A, et al. Fertility prognosis for infertile men: results of follow-up study of semen analysis in infertile men from two different populations evaluated by the Cox regression model. Fertil Steril 1990; 54: 1100–1106.PubMedGoogle Scholar
  53. 53.
    Barratt CLR, Macleod ID, Dunphy BC, et al. Prognostic significance of two putative sperm function tests: hypoosmotic swelling and bovine sperm mucus penetration test (Penetrak). Hum Reprod 1992; 7: 1240–1244.PubMedGoogle Scholar
  54. 54.
    MacLeod J, Gold RZ. The male factor in fertility and infertility. III. An analysis of motile activity in the spermatozoa of 1000 fertile men and 1000 men in infertile marriage. Fertil Steril 1951; 2: 187–204.PubMedGoogle Scholar
  55. 55.
    Boyers SP, Davis RO, Katz DF. Automated semen analysis. Curr Probl Obstet Gynecol Fertil 1989; 12: 165–200.Google Scholar
  56. 56.
    Marshburn PB, McIntire D, Carr BR, et al. Spermatozoal characteristics from fresh and frozen donor semen and their correlation with fertility outcome after intrauterine insemination. Fertil Steril 1992; 58: 179–186.PubMedGoogle Scholar
  57. 57.
    Davis RO. The promise and pitfalls of computer-aided sperm analysis. Infertil Rep rod Med Clin North Am 1992; 3: 341–352.Google Scholar
  58. 58.
    Baker HWG, Clarke GN. Sperm morphology: consistency of assessment of the same sperm by different observers. Clin Reprod Fertil 1987; 5: 37–43.PubMedGoogle Scholar
  59. 59.
    Dunphy BC, Kay R, Barratt CLR, et al. Quality control during the conventional analysis of semen, an essential exercise. J Androl 1986; 10: 378–385.Google Scholar
  60. 60.
    Clark RV, Sherins RJ. Use of semen analysis in the evaluation of the infertile couple. In: Santen RJ, Swerdloff RS, eds. Male Reproductive Dysfunction. New York: Marcel Dekker; 1986: 253–266.Google Scholar
  61. 61.
    Baccetti B, Burrini AG, Pallini V Spermatozoa and cilia lacking axoneme in an infertile man. Andrologia 1980; 12: 525–532.PubMedCrossRefGoogle Scholar
  62. 62.
    Cross NL, Morales P, Overstreet JW, et al. Two simple methods for detecting acrosome-reacted human sperm. Gamete Res 1986; 15: 213–226.CrossRefGoogle Scholar
  63. 63.
    Evenson DP, Darzynkiewicz Z, Melamed MR. Simultaneous measurement by flow cytometry of sperm cell viability and mitochondrial membrane potential related to cell motility. J Histochem Cytochem 1982; 30: 279–280.PubMedCrossRefGoogle Scholar
  64. 64.
    Zanaveld LJD, Jeyendran RS. Sperm function tests. Infertil Repro Med Clin North Am 1992; 3: 353–371.Google Scholar
  65. 65.
    Yanagimachi R. Mammalian fertilization. In: Knobil E, Neill J, eds. The Physiology of Reproduction. 2nd ed. New York: Raven Press; 1994: 189–317.Google Scholar
  66. 66.
    Overstreet JW, Yanagimachi R, Katz DF, et al. Penetration of human spermatozoa into the human zona pellucida and zona-free hamster egg-a study of fertile donors and infertile patients. Fertil Steril 1980; 33: 534–542.PubMedGoogle Scholar
  67. 67.
    Talbot P, Chacon RS. A new procedure for rapidly scoring acrosome reaction of human sperm. Gamete Res 1980; 3: 211–216.CrossRefGoogle Scholar
  68. 68.
    Wolf DP, Boldt J, Byrd W, et al. Acrosomal status evaluation in human ejaculated sperm with monoclonal antibodies. Biol Reprod 1985; 32: 1157–1162.PubMedCrossRefGoogle Scholar
  69. 69.
    Ohashi K, Saji F, Kato M, et al. Acrobeads test: a new diagnostic test for assessment of the fertilizing capacity of human spermatozoa. Fertil Steril 1995; 63: 625–630.PubMedGoogle Scholar
  70. 70.
    Cummins JM, Pember SM, Jequier AM, et al. A test of the human sperm acrosome parameters. J Androl 1991; 12: 98–103.PubMedGoogle Scholar
  71. 71.
    Falsetti C, Baldi E, Krausz C, et al. Decreased responsiveness to progesterone of spermatozoa in oligozoospermic patients. J Androl 1993; 14: 17–22.PubMedGoogle Scholar
  72. 72.
    Calvo L, Vantman D, Banks SM, et al. Follicular fluid-induced acrosome reaction distinguishes a subgroup of men with unexplained infertility not identified by semen analysis. Fertil Steril 1989; 52: 1048–1054.PubMedGoogle Scholar
  73. 73.
    Tesarik J. Comparison of acrosome reaction-inducing activities of human cumulus oophorus, follicular fluid and ionophore A23187 in human sperm populations of proven fertilizing ability in vitro. J Reprod Fertil 1985; 74: 383–388.PubMedCrossRefGoogle Scholar
  74. 74.
    Cross NL, Morales P, Overstreet JW, et al. Induction of acrosome reactions by the human zona pellucida. Biol Reprod 1988; 38: 235–244.PubMedCrossRefGoogle Scholar
  75. 75.
    Katz DF, Davis RO, Drobnis EZ, et al. Sperm motility measurement and hyperactivation. Semin Reprod Endocrinol 1993; 11: 27–39.CrossRefGoogle Scholar
  76. 76.
    Burkman LJ. Discrimination between nonhyperactivated and classical hyperactivated motility patterns in human spermatozoa using computerized analysis. Fertil Steril 1991; 55: 363–371.PubMedGoogle Scholar
  77. 77.
    Hurrowitz EH, Leung A, Wang C. Evaluation of the CellTrak computer-assisted sperm analysis system in comparison to the Cellsoft system to measure human sperm hyperactivation. Fertil Steril 1995; 64: 427–432.Google Scholar
  78. 78.
    Wang C, Leung A, Tsoi WL, et al. Evaluation of human sperm hyperactivated motility and its relationship with the zona-free hamster oocyte sperm penetration assay. J Androl 1991; 12: 253–257.PubMedGoogle Scholar
  79. 79.
    Hull MGR, Savage PE, Bromhan DR. Prognostic value of the post-coital test: prospective study based on time-specific conception rates. Br J Obstet Gynecol 1982; 89: 299–305.CrossRefGoogle Scholar
  80. 80.
    Moghissi KS. Cyclic changes of cervical mucus in normal and progestin-treated women. Fertil Steril 1966; 17: 663–675.PubMedGoogle Scholar
  81. 81.
    Katz DF, Overstreet JW, Hanson FW. A new quantitative test for sperm penetration into cervical mucus. Fertil Steril 1980; 33: 179–186.PubMedGoogle Scholar
  82. 82.
    Pandya IJ, Mortiner D, Sawers RS. A standardized approach for evaluating the penetration of human spermatozoa into cervical mucus in vitro. Fertil Steril 1986; 45: 357–360.PubMedGoogle Scholar
  83. 83.
    Feneux D, Serres C, Jouannet P. Sliding spermatozoa: a dyskinesia responsible for human infertility? Fertil Steril 1985; 44: 508–511.PubMedGoogle Scholar
  84. 84.
    Overstreet JW, Katz DF, Yudin AI. Cervical mucus and sperm transport in reproduction. Semin Perinatol 1991; 15: 149–155.PubMedGoogle Scholar
  85. 85.
    Kremer J, Jager J. The sperm-cervical mucus contact test: a preliminary report. Fertil Steril 1976; 27: 335–340.PubMedGoogle Scholar
  86. 86.
    Yanagimachi R, Yanagimachi H, Rogers BJ. The use of zona-free animal ova as a system for the assessment of the fertilizing capacity of human spermatozoa. Biol Reprod 1976; 15: 471–476.PubMedCrossRefGoogle Scholar
  87. 87.
    Aitken J. On the future of the hamster oocyte penetration assay. Fertil Steril 1994; 62: 17–19.PubMedGoogle Scholar
  88. 88.
    Gould JE, Overstreet JW, Yanagimachi H, et al. What functions of the sperm cell are measured by in vitro fertilization of zona-free hamster eggs? Fertil Steril 1983; 40: 344–352.PubMedGoogle Scholar
  89. 89.
    O’Shea DL, Odem RR, Cholewa C, et al. Longterm follow-up of couples after hamster egg penetration testing. Fertil Steril 1993; 60: 1040–1045.PubMedGoogle Scholar
  90. 90.
    Aitken RJ, Irvine DS, Wu FC. Prospective analysis of sperm-oocyte fusion and reactive oxygen species generation as criteria for the diagnosis of infertility. Am J Obstet Gynecol 1991; 164: 542–551.PubMedGoogle Scholar
  91. 91.
    Johnson A, Bassham B, Lipshultz LI, et al. A quality control system for the optimized sperm penetration assay. Fertil Steril 1995; 64: 832–837.PubMedGoogle Scholar
  92. 92.
    Aitken RJ, Thatcher S, Glasier AF, et al. Relative ability of modified versions of the hamster oocyte penetration test, incorporating hyper-osmotic medium or the ionophore A23187, to predict IVF outcome. Hum Reprod 1987; 2: 227–231.PubMedGoogle Scholar
  93. 93.
    Inoue M. Assessment of male fertility potential by zona-free hamster egg sperm penetration test. J Assist Reprod Genet 1993; 10: 27.Google Scholar
  94. 94.
    Muller CH. The andrology laboratory in an assisted reproductive technologies program. J Androl 1992; 13: 349–360.PubMedGoogle Scholar
  95. 95.
    Burkman LJ, Coddington CC, Franken DR, et al. The hemizona assay (HZA): development of a diagnostic test for the binding of human spermatozoa to the human hemizona pellucida to predict fertilization potential. Fertil Steril 1988; 49: 688–697.PubMedGoogle Scholar
  96. 96.
    Coddington CC, Oehninger SC, Olive DL, et al. Hemizona index (HZI) demonstrates excellent predictability when evaluating sperm fertilizing capacity in in vitro fertilization patients. J Androl 1994; 15: 250–254.PubMedGoogle Scholar
  97. 97.
    Liu DY, Lopata A, Leung A, et al. A human sperm-zona pellucida binding test using oocytes that failed to fertilize in vitro. Fertil Steril 1988; 50: 782–788.PubMedGoogle Scholar
  98. 98.
    Glezerman MG, Bartoov B. Semen analysis. In: Insler V, Lunenfeld B, eds. Infertility. New York: Churchill Livingstone; 1986: 243–271.Google Scholar
  99. 99.
    Francavilla F, Romano R, Gabriele AR, et al. Impaired hamster egg penetration by human sperm from ejaculates with low acrosin activity but otherwise normal. Fertil Steril 1994;61:735–740.Google Scholar
  100. 100.
    Goodpasture JC, Zavos PM, Cohen MR, et al. Relationship of human sperm acrosin and proacrosin to semen parameters. I. Comparison between symptomatic men of infertile couples and asymptomatic men, and between different split ejaculates. J Androl 1982; 3: 151–156.Google Scholar
  101. 101.
    Mohsenian M, Syner FN, Moghissi KS. A study of sperm acrosin in patients with unexplained infertility. Fertil Steril 1982; 37: 223–229.PubMedGoogle Scholar
  102. 102.
    Koukoulis G, Vantman D, Banks SM, et al. Low acrosin activity in a subgroup of men with idiopathic infertility does not correlate with sperm density, percent motility, curvilinear velocity, or linearity. Fertil Steril 1989; 52: 120–127.PubMedGoogle Scholar
  103. 103.
    Kennedy WP, Kaminski JM, Van der Ven HH, et al. A simple, clinical assay to evaluate the acrosin activity of human spermatozoa. J Androl 1989; 10: 221–231.PubMedGoogle Scholar
  104. 104.
    Tummon IS, Yuzpe AA, Daniel SAJ, et al. Total acrosin activity correlates with fertility potential after fertilization in vitro. Fertil Steril 1991; 56: 933–938.PubMedGoogle Scholar
  105. 105.
    Irvine DS, Aitkin RJ. The value of adenosine triphosphate (ATP) measurements in assessing the fertilizing ability of human spermatozoa. Fertil Steril 1985; 44: 806–813.PubMedGoogle Scholar
  106. 106.
    Huszar G, Corrales M, Vigue L. Correlation between sperm creatine phosphokinase activity and sperm concentrations in normospermic and oligospermic men. Gamete Res 1988; 19: 67–75.PubMedCrossRefGoogle Scholar
  107. 107.
    Huszar G, Vigue L, Corrales M. Sperm creatine phosphokinase activity as a measure of sperm quality in normospermic, variable spermic and oligospermic men. Biol Reprod 1988; 38: 1061–1066.PubMedCrossRefGoogle Scholar
  108. 108.
    Huszar G, Vigue L, Corrales M. Sperm creatine kinase activity in fertile and infertile oligospermic men. J Androl 1990; 11: 40–46.PubMedGoogle Scholar
  109. 109.
    Huszar G, Vigue L. Incomplete development of human spermatozoa is associated with increased creatine phosphokinase and abnormal morphology. Mol Reprod Dey 1993; 34: 292–298.CrossRefGoogle Scholar
  110. 110.
    Huszar G, Vigue L. Spermatogenesis-related change in the synthesis of the creatine kinase B-type and M-type isoforms in human spermatozoa. Mol Reprod Dey 1990; 25: 258–262.CrossRefGoogle Scholar
  111. 111.
    Huszar G, Vigue L. Sperm creatine phosphokinase M-isoform ratios and fertilizing potential of men: a blinded study of 84 couples treated with in vitro fertilization. Fertil Steril 1992; 57: 882–888.PubMedGoogle Scholar
  112. 112.
    Mori K, Daitoh T, Irahara M, et al. Significance of D-mannose as a sperm receptor site on the zona pellucida in human fertilization. Am J Obstet Gynecol 1989; 161: 207–211.PubMedGoogle Scholar
  113. 113.
    Benoff S, Cooper GW, Hurley I, et al. Human sperm fertilizing potential in vitro is correlated with differential expression of a head-specific mannose-ligand receptor. Fertil Steril 1993; 59: 854–862.PubMedGoogle Scholar
  114. 114.
    Benoff S, Cooper GW, Hurley IR, et al. Calcium-ion channel blockers and sperm fertilization. Assist Reprod Rev 1995; 5: 2–13.Google Scholar
  115. 115.
    Amann RP, Hammerstedt RH. In vitro evaluation of sperm quality: an opinion. J Androl 1993; 14: 397–406.PubMedGoogle Scholar
  116. 116.
    Jeyendran RS, Zaneveld LTD. Controversies in the development and validation of new sperm assays. Fertil Steril 1993; 59: 726–728.PubMedGoogle Scholar

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© Springer Science+Business Media New York 1997

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  • James W. Overstreet

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