Objective

To study geographic variations in sperm parameters using data from the trials that defined the reference ranges of the World Health Organization 2021 manual.

Design

Retrospective evaluation of the data used to define the World Health Organization reference ranges.

Setting

Not applicable.

Patient(s)

Data from 11 studies, including 3,484 participants across 5 continents.

Intervention(s)

The data were divided according to geographic locations.

Main Outcome Measure(s)

Differences in sperm parameters.

Result(s)

The semen volume was significantly lower in samples from Asia and Africa than in other regions. The sperm concentration was the lowest in Africa and highest in Australia. The total motile sperm count (TMSC) and total motile progressive sperm count (TMPS) were significantly lower in Africa than in other regions. The TMSC and TMPS in Asia and the United States were significantly lower than in Europe and Australia. The 5th percentile of the sperm concentration was lowest in the United States (12.5 × 10⁶/mL). The 5th percentile for the normal sperm morphology was lowest in the United States (3%) and highest in Asia (5%). The 5th percentile for the TMSC and TMPS were lowest in Africa (TMSC, 15.08 million; TMPS, 12.06 million) and the United States (TMSC, 18.05 million; TMPS, 16.86 million) and highest in Australia (TMSC, 29.61 million; TMPS, 25.80 million).

Conclusion(s)

Significant geographic differences in sperm parameters exist, and regional fertility societies should consider adding their own reference ranges on the basis of local experience and treatment outcomes.

中文翻译：

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世界卫生组织精液分析参考范围所用数据中精液参数的地理差异

客观的

使用定义世界卫生组织 2021 年手册参考范围的试验数据研究精子参数的地理差异。

设计

用于定义世界卫生组织参考范围的数据的回顾性评估。

环境

不适用。

患者）

来自 11 项研究的数据，包括来自 5 大洲的 3,484 名参与者。

干预措施

数据是根据地理位置划分的。

主要观察指标）

精子参数的差异。

结果）

来自亚洲和非洲的样本的精液量明显低于其他地区。精子浓度在非洲最低，在澳大利亚最高。非洲的总活动精子数 (TMSC) 和总活动精子数 (TMPS) 明显低于其他地区。亚洲和美国的 TMSC 和 TMPS 明显低于欧洲和澳大利亚。精子浓度的第 5 个百分位数在美国最低（12.5 × 10 ⁶/毫升）。正常精子形态的第 5 个百分位在美国最低 (3%)，在亚洲最高 (5%)。TMSC 和 TMPS 的第 5 个百分位数在非洲（TMSC，1508 万；TMPS，1206 万）和美国（TMSC，1805 万；TMPS，1686 万）最低，在澳大利亚最高（TMSC，2961 万；TMPS， 2580 万）。

结论

精子参数存在显着的地域差异，区域生育协会应考虑根据当地经验和治疗结果增加自己的参考范围。