![]() ![]() ![]() ![]() Infertility is defined as the “inability to achieve spontaneous pregnancy within one year of regular unprotected sexual intercourse”. ![]() This critical review of the 6th Edition of the WHO laboratory manual combined with a SWOT analysis summarizes the changes and novelties present in this new Edition and provides an in-depth analysis that could help its global use in the coming years. While this seems attractive, no decision limits are proposed for either basic semen parameters, or for extended or advanced parameters. The main novelty is that this latest edition abandons the notion of reference thresholds, suggesting instead to replace them with “decision limits”. The tests assessing sperm DNA fragmentation and seminal oxidative stress are well-described. This new Edition has made the analysis of basic semen parameters more robust, taking into account the criticisms and grey areas of the previous editions. Additionally, we evaluate the utility of this 6th Edition in clinical practice using SWOT (strengths, weaknesses, opportunities, and threats) analysis. In this review, we identify the key changes of this 6th Edition. The 6th Edition was published in July 2021. The first WHO manual was published in 1980, and five editions have been subsequently released over the last four decades. Semen analysis is the cornerstone of male fertility evaluation with WHO guidelines providing the basis for procedural standardization and reference values worldwide. ![]()
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