Semen analysis and external quality control schemes for semen analysis need global standardization

Abstract

One semen analysis laboratory [the Institute of Reproductive Medicine (IRM), Münster, Germany] was enrolled in three external quality assurance programmes in Europe (United Kingdom External Quality Assurance Scheme, European Academy of Andrology, European Society of Human Reproduction) that control for the assessment of sperm concentration, sperm motility and sperm morphology. Agreement between the participating laboratory and the sperm concentrations designated by all three programmes was good. Disagreement between two quality control (QC) programmes providing motility assessment was particularly noticeable in the distinction between motility grades a and b. For the identification of normal sperm morphology, marked differences between the standards set by different QC programmes were apparent. One programme was stricter in its categorization of normal forms, such that an overestimation of normal forms was diagnosed at IRM, whereas agreement with the other programmes was achieved. Variation of results from technicians in the IRM internal QC programme was <13%. The discrepancies between external quality control (EQC) centres demonstrated here are challenging problems to be overcome partly by the andrology laboratories and partly by the providers of EQC services. The introduction of objective, computer-aided sperm assessment in providing designated values may help to rectify this situation. Until this is achieved, EQC programmes should develop an internal programme to monitor their materials and methods for assessment.

Clinical relevance of routine semen analysis and controversies surrounding the 2010 World Health Organization criteria for semen examination

“…These data were corroborated by another study in which interlaboratory coefficient of variation was as high as 34% for sperm concentration, 20% for total sperm motility, 40% for sperm vitality, and 70% for sperm morphology (strict criteria) (39). Discrepancies were also seen in laboratories enrolled in quality control programs, thus indicating that there is a need of global standardization among the laboratories and the providers of external quality control (40).…”

External quality control program for semen analysis: Spanish experience

“…The temporal evolution of betweenlaboratories coefficients of variation is high, which suggest that in order to reduce these coefficients of variation it is necessary to implement another measures beyond the consolidation and standardisation of external quality control programmes, such as the creation of follow-up training courses and the standardisation of techniques (8).…”

“…Precise semen analysis is the most important test for determining fertility potential in the male, and the necessity for external quality control of this semen analysis has been highlighted in numerous studies (1)(2)(3)(4)(5)(6)(7)(8) and further afield (9).…”

Structural peculiarities associated with multiflagellate sperm in the emu, Dromaius novaehollandiae

“…Whereas various abnormal forms of spermatozoa have been named in the ostrich [5] and emu [6] but not described, and some morphological data provided on cytoplasmic droplets in ostrich sperm [7,8], the only comprehensive accounts of abnormal sperm structure in ratites are those on the emu [9][10][11]. The evaluation of sperm motility, sperm concentration and sperm morphology form the three most important parameters in semen analysis [12][13][14][15][16]. The importance of sperm morphology in the assessment of semen quality in ratites has been 3 recognised by Bertschinger et al [5] who note that in the ostrich "sperm morphology is the single most important factor in predicting fertility".…”