Fifteen years of Belgian experience with external quality assessment of semen analysis
Abstract
Semen analysis is difficult to standardize, quality control and quality assurance are necessary to ensure that results are accurate and precise. This Belgian EQA survey over a 15-year period, involving 121 laboratories, attempted to reduce interlaboratory variability and at the same time, encouraged participating laboratories to implement correct techniques as advised by the WHO. Over the total period, the median coefficient of variation (CV) for sperm count, irrespective of the method used was 19.2%, while using improved Neubauer chamber resulted in a significantly (p < 0.001) lower median CV (14.4%). The overall median CV for rapid progressive motility was high (37.1%), but progressive motility (15.1%) and total motility (13.8%) were acceptable. Sperm morphology revealed a large variability in 79.4% irrespective of the staining procedures or evaluation criteria used. Participation in the Belgian EQA is on voluntary basis. Both, participation and implementation of the correct techniques should be made mandatory for accreditation and benefit of patient treatment. The existing Belgian EQA program should now be harmonized with other existing EQA schemes in Europe.
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Punjabi et al. found that the overall coefficient of variation for PNS was 79.4% over the duration of their 15-year study.
“The overall coefficient of variation (CV) for PNS was 79.4% for the duration of the study.”
From Poor reproducibility of percentage of normally shaped sperm using the World Health Organization Fifth Edition strict grading criteria (2022) · cites this paper as Punjabi et al. [24]
In Punjabi et al., 20% of the results were discordant in the final year of the study when analyzed by PNS above or below the WHO5 threshold value.
“It is notable that 20% of the results were discordant in the final year of the study when analyzed by PNS above or below the WHO5 threshold value.”
From Poor reproducibility of percentage of normally shaped sperm using the World Health Organization Fifth Edition strict grading criteria (2022) · cites this paper as Punjabi et al. [24]
Punjabi et al. noted that performance improved after adoption of the WHO5 methods, but variation in morphology grading remained unacceptably high with an extrapolated PNS CV of ≥40% in the years after 2010.
“The investigators noted that performance improved after adoption of the WHO5 methods; however, the variation in morphology grading remained “unacceptably high” with an extrapolated PNS CV of ≥40% in the years after 2010.”
From Poor reproducibility of percentage of normally shaped sperm using the World Health Organization Fifth Edition strict grading criteria (2022) · cites this paper as Punjabi et al. [24]
Cites
The evaluation of morphological characteristics of human spermatozoa according to stricter criteria
Menkveld, R., Stander, F. S. H., Kotze, T. J. V., Kruger, T. F., & Zyl, J. A. V. (1990) · Human Reproduction · doi:10.1093/oxfordjournals.humrep.a137150 · Cited by 677 · see citing works
Barratt, C. L. R., Björndahl, L., De Jonge, C. J., Lamb, D. J., Osorio Martini, F., McLachlan, R., Oates, R. D., van der Poel, S., St John, B., Sigman, M., et al. (2017) · Human Reproduction Update · doi:10.1093/humupd/dmx021 · Cited by 505 · see citing works
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Barratt, C. L. R., Björndahl, L., De Jonge, C. J., Lamb, D. J., Osorio Martini, F., McLachlan, R., Oates, R. D., van der Poel, S., St John, B., Sigman, M., et al. (2017) · Human Reproduction Update · doi:10.1093/humupd/dmx021 · Cited by 505 · see citing works
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
“(24) published the outcomes of over 100 Belgian laboratories that participated in a thrice yearly voluntary external quality control (EQC) program for semen analysis over a 15-year period spanning the publication of WHO5.”
Background
- Authors
- Punjabi, U., Wyns, C., Mahmoud, A., Vernelen, K., China, B., & Verheyen, G.
- Affiliations
- Antwerp University Hospital (BE)
- Cliniques Universitaires Saint-Luc (BE)
- Ghent University Hospital (BE)
- Institut Scientifique de Santé Publique (BE)
- Universitair Ziekenhuis Brussel (BE)
- Corresponding author
- Punjabi, U.
- Venue
- Andrology
- Publisher
- Wiley
- Published
- 2016-07-13
- Volume
- 4
- Issue
- 6
- Pages
- 1084-1093
- ISSN
- 2047-2919 (ISSN-L)
- 2047-2927
- OpenAlex
- W2469737576
- Cited by
- 64
- References
- 2
- Citations by year
- 2026: 3 · 2025: 6 · 2024: 8 · 2023: 3 · 2022: 9 · 2021: 7 · 2020: 6 · 2019: 9 · 2018: 8 · 2017: 5
- FWCI
- 9.75
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Andrology (publishedVersion)
- PubMed (publishedVersion)
- Digital Access to Libraries (Université catholique de Louvain (UCL), l'Université de Namur (UNamur) and the Université Saint-Louis (USL-B)) (submittedVersion)
- VUBIR (Vrije Universiteit Brussel) (submittedVersion)
- Funders
- IPH departmental funds
- Topics
- Health Sciences › Medicine › Reproductive Medicine › Sperm and Testicular Function
- Health Sciences › Medicine › Physiology › Clinical Laboratory Practices and Quality Control
- Social Sciences › Decision Sciences › Statistics, Probability and Uncertainty › Scientific Measurement and Uncertainty Evaluation
- Keywords
- external quality assessment, semen analysis, inter-laboratory variability, sperm count, sperm motility, sperm morphology, Neubauer chamber, laboratory accreditation, quality assurance
- MeSH terms
- Belgium, Humans, Laboratories, Male, Quality Assurance, Health Care, Quality Control, Sperm Count, Sperm Motility, Semen Analysis
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