ABSTRACT
Male subfertility is the reason for the unfulfilled wish for children in approximately 50% of involuntary childless couples. In Germany alone, the number of childless partnerships amounts to 1.5-2.0 million, of which about 200 000 couples (10-13%) seek help by assisted reproduction yearly. In 2002, approximately 40 000 children were born in Germany after employing any form of assisted reproductive technologies (ART); 12 000 children were born after in vitro fertilization, constituting 1.6% of all births. The high incidence of male factor infertility mandates a complete andrological consultation in all male partners of couples consulting for infertility. Apart from the light microscopic determination of sperm count and morphological malformations, evaluation of functional sperm parameters has become a powerful tool in andrology laboratories. Some of these assays determine biochemical parameters, such as α-glucosidase1,2 or the polymorphonuclear granulocyte (PMN) elastase3,4, which have been found to be important for sperm function. Most, however, determine biological functions of spermatozoa (i.e. motility, membrane integrity, morphology, zona binding, acrosome reaction, acrosin activity, oolemma binding, chromatin condensation or DNA integrity) (Figure 19.1), and consequently the sperm cells’ capability
to fertilize oocytes. All of these parameters have repeatedly shown a significant relationship to both fertilization and pregnancy, in vitro and in vivo.
