title: Single vs. multiple semen specimens in screening for male infertility factors. A comparison.
abstract: OBJECTIVE
  To reevaluate the number of semen analyses necessary to establish whether further male infertility testing is necessary.
  
  
  METHODS
  The results of three consecutive semen analyses for infertility evaluations were retrospectively reviewed. A male factor was defined by an abnormal semen analysis if either the first specimen of three (single-sample screening) or two of the three specimens (multiple-sample screening) met World Health Organization criteria. Males considered abnormal by multiple-sample screening underwent sophisticated andrologic evaluation.
  
  
  RESULTS
  A single-sample conventional semen analysis obtained from 209 males demonstrated a diagnostic accuracy of 10.4% false negatives and a sensitivity of 89.6% when compared to that of multiple-sample analysis. Andrologic evaluation of abnormal males by multiple-sample screening confirmed that 9 of the 11 men with normal first specimens were abnormal; all others were confirmed as abnormal.
  
  
  CONCLUSIONS
  Analysis of multiple semen specimens provides a reliable screen in the evaluation of male factor infertility when the goal is to minimize the false negative rate of screening tests.
authors.affiliation: Department of Obstetrics and Gynecology, National Naval Medical Center, Bethesda, Maryland, USA.
authors.forename: M S
authors.initials: MS
authors.lastname: Opsahl
authors.forename: N G
authors.initials: NG
authors.lastname: Dixon
authors.forename: E R
authors.initials: ER
authors.lastname: Robins
authors.forename: D S
authors.initials: DS
authors.lastname: Cunningham
mesh_terms: D005188:False Negative Reactions; D006801:Humans; D007248:Infertility, Male / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology; D008297:Male; D008403:Mass Screening / Q000379:methods* / Q000592:standards; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D012661:Semen / Q000166:cytology / Q000502:physiology*; D012680:Sensitivity and Specificity; D013094:Spermatozoa / Q000166:cytology / Q000502:physiology; D014944:World Health Organization