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Recent studies have shown the effect of lifestyle factors on male fertility. Thus, the patient history and clinical\/andrological examinations have been broadened to include information on metabolic disorders like obesity and diabetes mellitus.<\/jats:p><jats:p>The biggest changes occurred with the publication of the fifth edition of the WHO laboratory manual in 2010 and the introduction of a section on semen analysis in the German Medical Association guidelines (RiliB\u00c4K). The reference values for almost all spermiogram parameters were adapted in an evidence\u2010based approach using worldwide prospective population studies. For central parameters such as sperm motility and morphology, the assessment criteria were changed. New independent markers such as sperm DNA fragmentation rate are now routinely used in clinical diagnosis. For German andrological laboratories, there are now mandatory quality assurance measures for semen analysis (in the German \u201cRili\u2010B\u00c4K\u201d guidelines). 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