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. Author manuscript; available in PMC: 2022 May 17.
Published in final edited form as: Fertil Steril. 2022 Jan 5;117(2):237–245. doi: 10.1016/j.fertnstert.2021.11.037

Table 2.

Changes in Reference Values from the 2nd to the 6th edition of the WHO laboratory manual for the examination and processing of human semen.

Edition Nomenclature Semen Volume (ml) Sperm concentration (106/ml)/Total number (106/ejaculate) Total/Progressive Sperm motility (%) Normal forms (%) Reference
2nd Normal Values ≥ 2 ≥20/≥40 ≥ 50/≥25 ≥50 Modified from (3–5), data from 1000 men with known fertility (female partner currently pregnant) and 1000 men in infertile marriage
3rd Normal Values ≥ 2 ≥20/≥40 ≥ 50/≥ 25 ≥30 Same as 2nd Edition Empirical value used for normal sperm forms
4th Reference values ≥ 2 ≥20/≥40 ≥ 50/≥ 25 * Same as 3rd Edition. * Normal forms - population-based studies of normal forms in progress, data from ART suggest <15 normal forms may be associated with decreased in vitro fertilization rate
5th Reference values of fertile men (5th centile lower reference limits) 1.5 15/39 40/32 4 Population based studies of about 1900 fertile men (defined as men whose partner conceived within 12 months after stopping contraception)(23). Morphology using “strict” criteria (8, 11).
6th Distribution of semen variables from fertile men (5th centile) 1.4 16/39 42/30 4 Population based studies of about 3500 fertile men (defined as men whose partner had a natural conception with a confirmed time to pregnancy of ≤ 12 months)(41).. Morphology using “strict” criteria (8, 11).