A continuous quality control program for strict sperm morphology

Abstract

Objective: To develop a training program with intervals of continuous quality control assessments for the evaluation of strict sperm morphology. Design: Prospective analytical study. Setting: Academic hospital and academic institution setting. Patient(s): Healthy sperm donors. Intervention(s): Nine individual andrology laboratories in Switzerland were invited to participate in a training course for strict sperm morphology, which was followed up every 3 months by a continuous quality control program. Each laboratory received six slides over a period of 9 months, during which time the results were forwarded to the reference laboratory. Papanicolaou stain sperm slides were prepared and shipped to participating laboratories every 3 months. Main Outcome Measure(s): Percentage of normal spermatozoa. Result(s): The mean (±SE) percentage of normal sperm reported by the reference laboratory compared with the participating laboratories for slides 1–6 were 11.4 ± 1.6 vs. 17.3 ± 6 ( P>.2), 6.0 ± 1.3 vs. 8.6 ± 2.5 ( P>.2), 9.0 ± 0 vs. 9.6 ± 3 ( P>.2), 1 ± 0 vs. 1.2 ± 0.2 ( P>.2), 23.3 ± 0.3 vs. 28.0 ± 1.3 ( P>.2), and 2.0 ± 0 vs. 6.1 ± 1.2 ( P>.2), respectively. Technician proficiency was reported to differ by <10% from the reference laboratory in 94% of cases. Conclusion(s): The results illustrate that training and proficiency testing can be conducted on a national and international level with the support of a reference laboratory. Global quality control measurements in andrology laboratories should become mandatory, since these results indicate that continuous quality control for laboratory technicians can be successful.