Abstract
Objective To determine the variability in the recognition of normal sperm and various sperm defects using the strict criteria recommended by the World Health Organization (5th edition, 2010).
Design Sperm morphologic assessment by three experienced evaluators.
Setting Image processing laboratory and reproduction research institute.
PATIENT(S): Semen donors from a sperm bank.
INTERVENTION(S): The morphology of 5,296 sperm was evaluated using statistical analyses of variability.
MAIN OUTCOME MEASURE(S): The proportion and coefficients of variation (CVs) of normal sperm, defects of specific parts, and the categories of defects were measured. The degree of agreement between any two of the three evaluators was calculated. The multiple anomalies index, teratozoospermia index, sperm deformity index, and the CVs were also measured.
RESULT(S): The CVs of normal sperm, multiple anomalies index, teratozoospermia index, and sperm deformity index were 4.80%, 4.14%, 5.75%, and 6.81%, respectively. A broader range (4.80%-132.97%) of CVs was observed for the recognition of various defects. The coefficients of the degree of agreement concerning specific morphologic parts of sperm varied (0.387-0.607), with lower relative values for the head and mid-piece than for the tail and cytoplasm.
CONCLUSION(S): The sperm head is more difficult to evaluate than the other parts using the criteria recommended by the World Health Organization in 2010. The degree of agreement concerning specific parts and various defects varied in broad ranges. A stricter definition for each defect is needed.
sperm morphology strict criteria WHO 2010 variability, inter-observer agreement semen analysis morphology assessment, sperm head defect evaluation coefficient of variation, WHO fifth edition sperm morphology classification, teratozoospermia index multiple anomalies index, sperm deformity index strict criteria assessment, semen analysis quality control morphology evaluation, normal sperm recognition variability evaluators, male factor infertility sperm morphology standardization, sperm defect classification head midpiece tail cytoplasm
PMID 24524830 24524830 DOI 10.1016/j.fertnstert.2013.12.047 10.1016/j.fertnstert.2013.12.047
Keywords
Adult, Cells, Cultured, China/epidemiology, Female, Humans, Infertility, Male/epidemiology/pathology, Male, Observer Variation, Practice Guidelines As Topic, Prevalence, Reproducibility of Results, Risk Assessment, Semen Analysis/standards/statistics & Numerical Data, Sensitivity and Specificity, Spermatozoa/pathology, Tissue Donors/statistics & Numerical Data, Young Adult, Sperm Morphology Assessment, Agreement Analysis, Evaluation Variability