Infertility: WHO semen reference limits: practice question

A OBG question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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OBG · Infertility: WHO semen reference limits

Sample item

According to the WHO 2021 (sixth edition) lower reference limits for semen analysis, which set of values is correct?

AVolume 5 mL, concentration 100 million/mL, total motility 90 percentBVolume 1.4 mL, concentration 16 million/mL, total motility 42 percentCVolume 3 mL, concentration 40 million/mL, total motility 60 percentDVolume 0.5 mL, concentration 5 million/mL, total motility 20 percent

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

B. Volume 1.4 mL, concentration 16 million/mL, total motility 42 percent

The WHO 2021 lower fifth-percentile limits are semen volume 1.4 mL, sperm concentration 16 million/mL, total number 39 million, total motility 42 percent, progressive motility 30 percent and normal forms 4 percent. These are reference limits, not thresholds of fertility. Abnormal results are repeated after at least 2 to 3 months.

Option by option

A. Volume 5 mL, concentration 100 million/mL, total motility 90 percent
These are unrealistically high values, not reference limits.
B. Volume 1.4 mL, concentration 16 million/mL, total motility 42 percent (correct)
Correct. These are the current lower reference limits.
C. Volume 3 mL, concentration 40 million/mL, total motility 60 percent
These resemble outdated or higher median values and not the limits.
D. Volume 0.5 mL, concentration 5 million/mL, total motility 20 percent
These values are well below the reference limits.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

Questions about this OBG question

What is the answer to this OBG question?

The best answer is B, Volume 1.4 mL, concentration 16 million/mL, total motility 42 percent. The WHO 2021 lower fifth-percentile limits are semen volume 1.

Why is "Volume 5 mL, concentration 100 million/mL, total motility 90 percent" not the answer?

These are unrealistically high values, not reference limits.

Why is "Volume 3 mL, concentration 40 million/mL, total motility 60 percent" not the answer?

These resemble outdated or higher median values and not the limits.

Why is "Volume 0.5 mL, concentration 5 million/mL, total motility 20 percent" not the answer?

These values are well below the reference limits.

What concept does this question test?

It tests Infertility: WHO semen reference limits in OBG. 4 mL, sperm concentration 16 million/mL, total number 39 million, total motility 42 percent, progressive motility 30 percent and normal forms 4 percent. These are reference limits, not thresholds of fertility. Abnormal results are repeated after at least 2 to 3 months.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Infertility: WHO semen reference limits?

Learn management algorithms as steps: PPH, eclampsia, ectopic pregnancy. Then use the flashcards and the other OBG questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.