Implementing comprehensive quality control in the andrology laboratory.

Comprehensive quality control procedures were integrated into the routine semen analysis workload of a large university-based andrology laboratory. Methods were chosen to match as far as possible those which have been used successfully for many years in disciplines such as clinical chemistry. Levey-Jennings and cusum charts were plotted in order to monitor the immunobead-binding test for antisperm antibodies and a video-taped control sample for computerized semen analysis. A cryopreserved semen control was also charted. Daily manual sperm counts were plotted against the corresponding computer-assisted semen analysis (CASA) value. Multiple readings of 30 slides were used to monitor morphology assessments. Monthly means for morphology were also calculated regularly. Coefficients of variation were calculated for all variables and were found to be more appropriate for some aspects, such as CASA, than for others, such as morphology, when difference from the previous reading of the same slide was found to be more useful. These integrated quality control procedures had a direct influence on the production of results from the laboratory. Together with a high standard of technician training, comprehensive routine quality control based on repeated analyses of control samples is an effective way of assuring the validity of semen analysis results.