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Although semen analysis is the main routine test used in the diagnosis of male infertility, it is considered to be poorly predictive of male fertility status. Only recently, research in sperm biology focused on the development of assays to evaluate sperm functions necessary to reach and fertilize the oocyte and to allow a correct embryo development. However, the clinical utility of the currently proposed tests/assays remains a matter of debate, especially after introduction of ICSI. Ideally, since fertilization proceeds in a cascade-like manner, the goal would be to develop a single test able to evaluate all the aspects involved in this process and introduce it in ART laboratories. Such test should be simple, cheap, and not requiring expensive technology. Unfortunately, this aim is still far from being achieved. In this chapter, we discuss the most promising tests assessing sperm functions, describing their validity, limits, and potential use in clinical practice.
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