Prior paternity as a predictor of semen quality

Objective: Little is known about the predictive value of prior paternity in men with no identifiable causes for infertility at initial presentation. This study was conducted to determine if the history of having fathered a child obviates obtaining a semen analysis in a couple with secondary infertility. Methods: A retrospective evaluation of semen parameters and paternity factors was performed among men with no known male infertility factor. The World Health Organization criteria was used to define a normal semen analysis. Semen parameters of all men who had previously fathered a child and were seen for evaluation of secondary infertility from Jan. 1 to Dec. 31, 1994, were reviewed. The variables evaluated included paternity factors (age, number of children, years since last pregnancy established), sperm concentration, motility, morphology, white blood cell count per high- power field, agglutination, and documented evidence of sperm antibodies. Results: At least one abnormality was noted in over 70% of semen parameters in 55 men with prior paternity. The most common abnormalities were agglutination and/or presence of antisperm antibodies shown by immunobead tests. There were no significant correlations between any semen parameters and paternity factors. Summary: In nearly three quarters of these semen analyses reviewed, at least one abnormality was identified. Conclusion: Prior paternity is a poor predictor of normal semen quality. Complete semen analyses should therefore be performed in all men in a secondary infertility evaluation regardless of prior paternity. Abnormalities can then be identified and appropriate evaluation and therapy initiated early in both partners.