Page 86 - PRECONGRESS COURSE 01

Value of WHO guidelines for semen analysis: A plea for standardized methodology Learning objectives and summary
 Semen analysis is the most important surrogate parameter for male fertility.
 WHO has pioneered standardisation of semen analysis and in order to obtain
reliable and comparable results, WHO guidelines must be strictly followed.
 Like all other clinical laboratory tests semen analysis should be under strict
internal and external quality control.
 However, many laboratories fail to follow these guidelines so that it remains
unclear whether the the wide scatter of results in inter‐laboratory tests
is caused by protocol failures or is inherent to semen analysis.
 The dimension of protocol failures became evident in a recent survey among
participants of the QuaDeGA external quality control program: many laboratories lack basic equipment (mixers, vortex, proper pipettes) and appropriate microscopes, do not use the recommended improved Neubauer chambers, use inappropriate staining methods and do not evaluate sufficient sperm.
 Laboratories performing more than 20 semen analyses per month score better than those with lower sample frequency.
 Laboratories without Internal QC have a high failure rate in External QC.
 Teaching and practical training of technicians and observing WHO guidelines appears
to be the most important measure to standardize methods and harmonize results.
 Before better agreement of results within and inbetween laboratories is achieved,
arguing over normal, reference and threshold values appears meaningless.
Antonius A. Leeuwenhoek (1632 – 1723)
Inventor of the microscope
and first to observe and describe sperm
Royal Society
BC 158 Phil. Trans. XII, 1678, Letter 38
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