Andrology: The predictive value of computer-assisted semen analysis in the context of a donor insemination programme

In this paper we examine the value of both conventional andcomputer-assisted semen analysis (CASA) using the Hamilton-ThornHTM-S 2030 in predicting the in-vivo fertility of cryopreserveddonor semen. Semen samples were examined prospectively and dataon the conventional criteria of semen quality, sperm morphometryand movement were collected. Of 61 ejaculates identified, 33achieved pregnancies (‘successful’) and 28 failedto do so (‘unsuccessful’), despite inseminationinto at least four different normal female recipients. Whenthe post-thaw semen profiles were compared, no differences wereobserved between the two groups in respect of the conventionalcriteria of semen quality determined by conventional laboratorytechniques; however, there were differences in respect of bothmorphometry and movement characteristics determined by the HTM-S.When multiple logistic regression was used to examine the abilityof the variables measured to predict the achievement of pregnancy,the conventional criteria of semen quality were of no value(X² = 6.67, P = 0.353). However, the CASA assessment successfullypredicted outcome in 86.9% of cases (X² = 44.3, P = 0.0021).It was concluded that CASA assessment is of significant valuein predicting the ability of an ejaculate to achieve pregnancy.