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Background New reference values for semen parameters are significantly lower in the WHO 5th edition (2010) than in the 4th edition [1,2]. Some of the highlights of the fifth edition were: 1) subjects included in this edition had < 12 months’ time to pregnancy, 2) semen analyses results were pooled and analyzed for reference values, 3) laboratories generating the data used standardized methods for semen analysis according to WHO manual available at the time of original studies and 4) one-sided lower reference limits (5th centile) were generated and proposed as lower cut-off limits for normal values. The new reference values were aimed at providing evidencebased thresholds to assist clinicians in calculating relative fertility of the patient. The goal of our study was to examine the impact of the new WHO reference values on the referral pattern of infertile men referred for assisted reproduction (IUI, IVF/ICSI).

Impact of World Health Organization (WHO) new standards on the referral pattern of infertile men for assisted reproduction