TOTAL MOTILE SPERM COUNT TREND OVER TIME: EVALUATION OF SEMEN ANALYSES FROM 119,972 MEN FROM SUBFERTILE COUPLES

Abstract Objective To determine whether a clinically-relevant change in the total motile sperm count (TMSC) over time exists within the subfertile population. Methods The first semen analysis of all men presenting to selected infertility centers in two countries between 2002 and 2017 were evaluated. Semen analyses were categorized into three clinically-relevant groups based on treatment options: TMSC > 15 million (M) (Group 1), in which no insemination intervention would be required; TMSC 5 - 15M (Group 2), in which intrauterine insemination would be appropriate; and TMSC of Results A total of 119,972 first semen analyses were included. The proportion of men with normal TMSC (>15M) was found to decline approximately 10 percentage points over the past 16 years in the analysis of combined centers (OR 0.967; 95% CI = 0.963-0.971; p =2.2e-16). A reciprocal increase was distributed between both the moderate (5-15M) and severe ( Conclusion The proportion of men with normozoospermia declined and that of men at risk of requiring fertility treatment increased over the study time period. Although several unknown factors may have influenced our data as a result of the retrospective design, a shift in treatment group membership over time may be clinically relevant.