Sperm morphology assessment using David’s classification: time to switch to strict criteria? Prospective comparative analysis in a selected IVF population

Abstract

The aim of this study was to compare assessment of sperm morphology by using David's classification (DC), a method of manual analysis most common in France, with a computer-assisted method (Integrated Visual Optical System) based on the strict criteria (CASA SC) for their ability to predict fertilization in a selected in vitro fertilization (IVF) population. A total of 120 couples engaged in IVF protocols were prospectively included in the study. To focus mainly on sperm morphology, couples were excluded in cases of abnormalities of sperm concentration and/or motility and immunological factors and when a low number of oocytes were collected. Sperm morphology analysis was performed on the day of oocyte retrieval by the same trained biologist. Our results showed a moderate correlation between the two techniques (r = 0.49). The DC sperm morphology analysis was less indicative of fertilization than CASA SC (r = 0.07, p = 0.47 vs. r = 0.22, p = 0.014). Using receiver-operating characteristics analysis, we showed that DC was not discriminating in the prediction of fertilization (AUC = 0.572). DC seemed less appropriate for the prediction of fertilization success or failure. In contrast, with CASA SC, the previously determined cut-off value of around 14% was confirmed (AUC = 0.735, cut-off = 6%). Our results argue in favour of the replacement of DC by SC to tend towards worldwide standardization.

Semen quality trends in French regions are consistent with a global change in environmental exposure

“…For sperm concentration and motility, French experts confirmed that the methods have not changed noticeably during the study period (Rolland et al 2013). Regarding morphology classification, a majority of the laboratories used David's classification during the study period (Blanchard et al 2011). …”

High body mass index has a deleterious effect on semen parameters except morphology: results from a large cohort study

“…This is in contrast to the Shayeb et al (6) paper, where data were collected over 18 years. The use of a modified David classification (13,14) in our laboratory for morphology (18) is based on experience and constitutes a standard method in France (19), even if it does not really allow for international comparisons on morphology. However, all other sperm parameters were analyzed according to WHO manual (12) and can be compared.…”

“…A routine analysis included assessment of pH, semen volume (mL), sperm concentration (million/mL), total sperm count (million), percentage motility (overall and progressive), and percentage normal forms. Sperm morphology was assessed according to a modified David classification (13,14) after Harris-Schorr staining. Concentration and total sperm count were quoted as ''0'' in cases of azoospermia.…”

Evaluation of morphological criteria of sperm quality before in vitro fertilization and intracytoplasmic sperm injection

“…Subsequently the anomalies are classified using strictly defined criteria. By contrast, computer-assisted technology measures different morphological features (mostly head parameters) for each selected sperm cell (van der Horst et al 2009, Auger 2010, Bellastella et al 2010, Blanchard et al 2011, Butts et al 2011. Therefore, the parameters of normal sperm can differ according to staining method of sperm sample (Maree et al 2010).…”