Computer assisted semen analyzers in andrology research and veterinary practice

Testicular biopsy is a crucial assessment in reproductive practice with diagnostic and prognostic importance for assisted reproductive technologies (ARTs) and risk of testicular neoplasia. Endocrine and genetic tests cannot reliably distinguish obstructive azoospermia (OA) from non-obstructive azoospermia (NOA) or predict recovery of mature spermatids by testicular sperm extraction (TESE). Currently, divergent histological reporting systems and the use of imprecise terminology seriously degrade the value of the literature on TESE recovery rates and hamper evaluation of treatments and research on genotype-phenotype relationships. The rising incidence of testis cancer and carcinoma in situ (CIS), especially in infertile populations, requires that every effort be made for its early detection. We provide a systematic approach to the histological classification of spermatogenic disorders and detection of CIS in adult patients. We evaluate a large consecutive series of bilateral biopsies from infertile men and report (i) the frequency of bilateral or discordant patterns that supports the use of bilateral biopsy for comprehensive evaluation and (ii) a high prevalence of mixed patterns, particularly within the hypospermatogenesis classification, that helps account for reported success of TESE. We propose a new diagnosis code for testicular biopsies that addresses the needs of ART clinicians and allows data storage and retrieval of value in clinical practice and research.

Histological evaluation of the human testis--approaches to optimizing the clinical value of the assessment: mini review

External quality control in the andrology laboratory: an experimental multicenter trial.

The aim of the present study was to assess variability in the evaluation of human sperm concentration, motility and vitality. Technicians and biologists from 10 teams involved in multicentre studies on semen quality attended the same laboratory, each team using its own methods and equipment to analyse the same semen samples. Inter-individual variability was assessed from 17 fresh semen samples of varying quality. Intra-individual variability was assessed from pools of frozen samples for sperm concentration and motility and stained smears for vitality with three blind evaluations by sample and smear. The mean inter-individual coefficients of variation were 22.9, 21.8 and 17.5% for sperm concentration, motility and vitality respectively. There was no statistical difference among participants for sperm concentration assessment, but significant differences for both motility and vitality (both P: < 0.05). The mean intra-individual coefficients of variation were 15.8, 26.2 and 13.1% for sperm concentration, motility and vitality respectively, with marked differences between expert and novice participants: concentration 9.8% versus 28.0%; motility 22.8% versus 33.0%; and vitality 10.0% versus 19.3%. The present data confirm the need for external quality control schemes for diagnostic purposes, and indicate their utmost importance in multicentre studies on semen quality.

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Intra- and inter-individual variability in human sperm concentration, motility and vitality assessment during a workshop involving ten laboratories

Internal quality control of semen analysis

The paper reports a study of standardization and quality control of sperm concentration counts and visual motility assessments in human semen analyses performed for infertility investigations and from internal quality control procedures. Sperm concentration determinations were performed in Improved Neubauer haemocytometers on volumetric dilutions made using a positive displacement pipettor for sampling the liquefied semen. In addition to a standard 1 + 19 dilution a second dilution of either 1 + 9, 1 + 19 or 1 + 49 was made according to whether the estimated sperm concentration was less than 20, 20-100 or greater than 100 X 10(6)/ml respectively. The duplicate determinations of sperm concentration were highly significantly correlated (P much less than 0.001) with less than 5% variability. Parallel visual sperm motility assessments were made by two pairs of technicians and showed highly significant correlations (P much less than 0.001) between technicians in the determination of the percentages of motile and progressive spermatozoa as well as the subjective rating of sperm progressivity. When these values were incorporated into a calculated motility index which gave added weight to the progressive spermatozoa and to their quality of progression the correlations between technicians remained highly significant (P much less than 0.001) with average differences of the order of 1.0%. Therefore, provided that sufficient attention is paid to technician training, regular standardization checks and the use of only proven reliable procedures, quantitatively accurate values for sperm concentration and motility can be obtained in routine semen analyses.

Standardization and quality control of sperm concentration and sperm motility counts in semen analysis.

A comparison was made of the use of either an SMI positive displacement pipette or an Eppendorf Varipette as the method of sampling 63 liquefied semen samples for volumetric dilution and haemocytometry to determine sperm concentration. The 95% range of the differences between the values obtained using the SMI and the Varipette with whole tips was from -46.9 to 63.8 x 10(6)/ml. With the Varipette tips cut off 12.5 mm from the end the 95% range was from -52.4 to 55.8 x 10(6)/ml. Previous work had shown that the 95% ranges of differences between duplicate determinations using the SMI pipette were from -7.2 to 6.9 x 10(6)/ml for two 1 + 19 dilutions, or from -16.0 to 12.1 x 10(6)/ml for 1 + 19 and 1 + 49 parallel dilutions. Therefore, since the Varipette had a far greater potential for error, a positive displacement pipette should be used when taking precise volume aliquots of human semen.

R. Tan

Papers

Standardization and quality control of sperm concentration and sperm motility counts in semen analysis.

A technical note on diluting semen for the haemocytometric determination of sperm concentration