Variability in the morphologic assessment of human sperm: use of the strict criteria recommended by the World Health Organization in 2010
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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 variou…
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Wang et al. found that the mean PNS was 20.87% and the CV was 4.8%.
“The investigators found that the mean PNS was 20.87% and the CV was 4.8%.”
From Poor reproducibility of percentage of normally shaped sperm using the World Health Organization Fifth Edition strict grading criteria (2022) · cites this paper as Wang et al. [26]
Wang et al. found that agreement among graders for the overall PNS was good (κ = 0.47-0.52).
“Agreement among the graders for the overall PNS was good (κ = 0.47–0.52).”
From Poor reproducibility of percentage of normally shaped sperm using the World Health Organization Fifth Edition strict grading criteria (2022) · cites this paper as Wang et al. [26]
Wang et al. reported good agreement for PNS but moderate or worse agreement for categorization of sperm defects among experienced graders.
“In 2014, Wang et al. (26) reported good agreement for PNS but moderate or worse agreement for categorization of sperm defects among experienced graders.”
From Poor reproducibility of percentage of normally shaped sperm using the World Health Organization Fifth Edition strict grading criteria (2022) · cites this paper as Wang et al. [26]
Cited by
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Kohn, T. P., Kohn, J. R., & Ramasamy, R. (2018) · Journal of Urology · doi:10.1016/j.juro.2017.11.045 · Cited by 56 · see citing works
Baker, K. C., Steiner, A. Z., Hansen, K. R., Barnhart, K. T., Cedars, M. I., Legro, R. S., Diamond, M. P., Krawetz, S. A., Usadi, R., Baker, V. L., et al. (2022) · F&S Reports · doi:10.1016/j.xfre.2022.03.003 · Cited by 14 · see citing works
van den Hoven, L., van Vrouwerff, N. J., Dijkstra, I. M., Weeteling, J., Brinkman, J. W., Eliveld, J., & Wetzels, A. M. M. (2025) · Andrology · doi:10.1111/andr.13684 · Cited by 4 · see citing works
- Authors
- Wang, Y., Yang, J., Jia, Y., Xiong, C., Meng, T., Guan, H., Xia, W., Ding, M., & Yuchi, M.
- Affiliations
- Huazhong University of Science and Technology (CN)
- Wuhan National Laboratory for Optoelectronics (CN)
- Corresponding author
- Yuchi, Ming
- Venue
- Fertility and Sterility
- Publisher
- Elsevier BV
- Published
- 2014-04
- Volume
- 101
- Issue
- 4
- Pages
- 945-949
- ISSN
- 0015-0282 (ISSN-L)
- OpenAlex
- W1994736160
- Cited by
- 55
- References
- 0
- Citations by year
- 2026: 1 · 2025: 1 · 2024: 9 · 2023: 12 · 2022: 6 · 2021: 4 · 2020: 5 · 2019: 7 · 2018: 3 · 2017: 4 · 2016: 2 · 2015: 1
- FWCI
- 2.83
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Fertility and Sterility (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Reproductive Medicine › Sperm and Testicular Function
- Health Sciences › Medicine › Reproductive Medicine › Reproductive Health and Technologies
- Health Sciences › Health Professions › General Health Professions › Male Reproductive Health Studies
- Keywords
- sperm morphology, sperm abnormalities, interobserver variability, teratozoospermia, sperm head, semen analysis
- MeSH terms
- Adult, Cells, Cultured, China, Female, Humans, Infertility, Male, Male, Sensitivity and Specificity, Spermatozoa, Tissue Donors, Reproducibility of Results, Observer Variation, Prevalence, Practice Guidelines as Topic, Risk Assessment, Semen Analysis, Young Adult
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