Laboratory techniques for semen analysis: a Scottish survey.

OBJECTIVE

To survey the techniques used by Scottish laboratories to undertake semen analysis in the context of the investigation of infertility.

DESIGN

A telephone survey.

SETTING/SUBJECTS: Laboratories in Scotland performing semen analysis.

RESULTS

Thirty-one laboratories reported performing semen analysis for infertility. There was a lack of consistency in the instructions given to patients in several areas, including the period of abstinence prior to producing the specimen and the delivery of the specimen to the laboratory within an appropriate time after ejaculation. Only 19% of laboratories reported using a positive displacement pipette in the dilution of semen and only 26% used phase contrast microscopy for routine semen analysis. The minimum normal values quoted by laboratories for sperm concentration ranged from 20 x 10(6)/ml to greater than 50 x 10(6)/ml. The normal values quoted for sperm morphology ranged from at least 30% normal forms to at least 88% normal forms. Only 13% of laboratories participated in any form of internal or external quality control for semen analysis.

CONCLUSIONS

Semen analysis is fundamental to the clinical work up of the infertile couple but, unlike most other laboratory investigations, it is not a standardised test in Scotland. Factors which are known to influence the results such as the advice given to patients about collecting specimens and the methods and equipment used by technicians vary widely. There is not even a consensus on the normal values quoted. This has implications for clinical decisions based on semen analysis and for future accreditation of laboratories.