School of Health & Sport Science and School of Nursing, Eastern Institute of Technology, Taradale Campus, Hawkes Bay, New Zealand.
Andrology Laboratory, Hammersmith Hospital, Imperial College NHS Trust, London, UK.
Hum Fertil (Camb). 2021 Jul;24(3):208-218. doi: 10.1080/14647273.2019.1610581. Epub 2019 May 6.
Semen analysis (SA) is considered mandatory for suspected male infertility although its clinical value has recently become questionable. Sperm motility is an essential parameter for SA, but is limited by high measurement uncertainty, which includes operator subjectivity. Computer-assisted sperm analysis (CASA) can reduce measurement uncertainty compared with manual SA. The objective of this study was to determine whether the Sperm Class Analyser (SCA) CASA-Mot system could reduce specific components of sperm motility measurement uncertainty compared with the World Health Organization (WHO) manual method in a single laboratory undertaking routine diagnostic SA. The study examined: (i) operator subjectivity; (ii) precision, (iii) accuracy against internal and external quality standards; and (iv) a pilot sub-study examining the potential to predict an IVF fertilisation rate. Compared with the manual WHO method of SA on 4000 semen samples, SCA reduces but does not completely eliminate operator subjectivity. Study SCA and CASA-Mot are useful tools for well-trained staff that allow rapid, high-number sperm motility categorization with less analytical variance than the manual equivalent. Our initial data suggest that SCA motility may have superior predictive potential compared with the WHO manual method for predicating IVF fertilization.
精液分析(SA)被认为是疑似男性不育症的强制性检查,尽管其临床价值最近受到质疑。精子活力是 SA 的一个重要参数,但受到测量不确定度的限制,包括操作人员的主观性。计算机辅助精子分析(CASA)可以降低与手动 SA 相比的测量不确定度。本研究的目的是确定在一个进行常规诊断 SA 的单一实验室中,与世界卫生组织(WHO)手动方法相比,Sperm Class Analyser(SCA)CASA-Mot 系统是否可以降低精子运动性测量不确定度的特定成分。该研究检查了:(i)操作人员的主观性;(ii)精密度,(iii)对内部和外部质量标准的准确性;以及(iv)一项试点子研究,检查预测体外受精受精率的潜力。与 4000 个精液样本的手动 WHO 方法相比,SCA 降低了但并未完全消除操作人员的主观性。研究 SCA 和 CASA-Mot 是熟练工作人员的有用工具,允许快速、高数量的精子运动分类,其分析方差小于手动等效方法。我们的初步数据表明,与 WHO 手动方法相比,SCA 活力可能具有更好的预测体外受精受精率的潜力。