Semen analysis graded against WHO 2021, not typed into a box

The spermiogram, parameter by parameter

A semen analysis is a set of independent measurements, each with its own unit and its own reference limit, and storing it as a wide row of columns makes the reference framing invisible. FertiliCore normalises the spermiogram into one row per measured parameter, linked to a shared catalogue that carries the WHO 2021 sixth-edition lower and upper limits. The analysis screen renders that catalogue as a grid — parameter, unit, WHO 2021 reference, the editable value, and a status badge — and each entered value is compared against its limits and badged normal or abnormal. Where a parameter has no seeded limit the grid says so plainly rather than implying a judgement, and a blank value reads as not measured rather than as normal.

Pre-analytic conditions are part of the result

WHO methodology treats abstinence, time to analysis and collection conditions as part of the measurement, because a concentration figure without them is not comparable. The analysis header records the sample date and time of production, days of ejaculatory abstinence, how the sample was obtained, where it was produced, and how it was counted — manually, by CASA, or by MSOME. It also records the analysis type, which is what separates a basal diagnostic spermiogram from a post-preparation or post-wash count used to plan IUI, IVF or ICSI, and from pre-freeze, post-freeze, donor, TESE and PESA samples. The performing embryologist and responsible physician are named on the record, and a finalised analysis can be locked read-only.

• Abstinence in days, a WHO pre-analytic variable
• Collection by masturbation, TESA, TESE, PESA or donor
• Collection on site, at home, or externally
• Counting method: manual, CASA or MSOME

MSOME and the case for IMSI

Motile sperm organelle morphology examination assesses living, motile spermatozoa at high magnification, above 6000×, principally to score head vacuoles. It is the evidence a laboratory uses to decide whether a case warrants intracytoplasmic morphologically selected sperm injection rather than standard ICSI. The record captures the number of spermatozoa scored and the breakdown into normal, large-vacuole, small-vacuole and other-defect counts with the derived normal and large-vacuole percentages, alongside the recommended action. Those figures render on the standalone MSOME report and on the combined IMSI document, which pairs the spermiogram with the high-magnification assessment.

The count at the injection bench

The count that determines what actually happened on the day of ICSI is the one performed at the bench, not the diagnostic sample taken weeks earlier. FertiliCore models an ICSI-bench spermiogram owned by the embryology session, holding volume, concentration, progressive and total motility and normal morphology, the preparation technique used, the post-preparation motility and the number of sperm selected for injection. Because it hangs off the session rather than off the patient alone, the sample quality used for a given cycle stays attached to that cycle's laboratory work.

Male-factor history, diagnosis and the composite view

Male-factor work-up is broader than a single count. The system models the full structured infertility questionnaire — reproductive, surgical, systemic, urological, genetic, sexual, lifestyle, physical examination and prior-treatment sections — as well as a lighter narrative history for quick note-taking. The andrology diagnosis is coded against a seeded catalogue of male diagnosis types grouped by the parameter they affect, with an optional diagnosis code, free-text description and severity. Above these sits a composite male-factor evaluation that ties the semen findings to the endocrine profile and the genetic results and states a recommended route, which is the summary a clinician actually counsels from.

• Serum FSH, LH, testosterone and inhibin B held together
• Karyotype and Y-chromosome microdeletion results
• Obstructive versus non-obstructive azoospermia
• Varicocele grade and overall assessment narrative

Sperm FISH sits between andrology and genetics

Fluorescence in-situ hybridisation on sperm nuclei measures chromosomal aneuploidy rates directly, which matters in severe male factor, recurrent pregnancy loss and repeated implantation failure. Clinically it is a sperm diagnostic; operationally it is run by the genetics laboratory, and FertiliCore models it accordingly, in the genetics schema with a link to the external genetic centre that performed it. The header holds the sample date, the number of nuclei scored, the probe panel and the result date, with child rows carrying disomy, nullisomy and diploidy percentages for each chromosome examined. Both the plain and the aneuploidy-focused report templates render from those rows.