External quality control program for semen analysis: Spanish experience

  • C. Álvarez
  • J. A. Castilla
  • J. P. Ramírez
  • F. Vergara
  • A. Yoldi
  • A. Fernández
  • J. J. Gaforio


Purpose: Results from an external quality control programme for semen analysis carried out in Spain are analysed.

Methods: Quality control materials were distributed and the following seminal parameters were determined: concentration, total motility, progressive motility, rapid progressive motility, morphology and sperm vitality. The between-laboratories coefficients of variation were assessed on different types of quality control material.

Results: The majority of participating laboratories utilised manual versus computer-assisted semen analysis methods. Some between-laboratories coefficients of variation ranges were: 20.8–33.8% for concentration (semen pool suspension); 13.9–19.2% for total motility (videotapes); 54.2–70.2% for sperm morphology (strict criteria using stained smears); and 9.8–41.1% for sperm vitality (stained smears). There was an inverse relation between mean percentage of sperm and coefficients of variation between laboratories for sperm motility, morphology and vitality.

Conclusions: These data highlight the urgent need for improvement in the overall quality of andrology testing.


External quality control semen analysis sperm concentration sperm morphology sperm motility 


  1. 1.
    Neuwinger J, Behre HM, Nieschlag E: External quality control in the andrology laboratory: An experimental multicenter trial. Fertil Steril 1990;54:308–314PubMedGoogle Scholar
  2. 2.
    Matson PL: External quality assessment for semen analysis and sperm antibody detection: Results of a pilot study. Hum Reprod 1995;10:620–625PubMedCrossRefGoogle Scholar
  3. 3.
    Clavert A, Bourguignat A, Férard G: Quality control in spermiology: The French experience. Symposium Abstracts, IFCC-Worldlab'99, Firenze, 6–11 June. Clin Chem Lab Med 1999;37:S1–S101Google Scholar
  4. 4.
    Cooper TG, Atkinson AD, Nieschlag E: Experience with external quality control in spermatology. Hum Reprod 1999;14:765–769CrossRefPubMedGoogle Scholar
  5. 5.
    Gandini L, Menditto A, Chiodo F, Lenzi A: Italian pilot study for an external quality control scheme in semen analysis and antisperm antibodies detection. Int J Androl 2000;23:1–3CrossRefPubMedGoogle Scholar
  6. 6.
    Keel BA, Quinn P, Schmidt Jr CF, Serafy Jr NT, Serafy NT, Schalue TK: Results of the American Association of Bioanalysts national proficiency testing programme in andrology. Hum Reprod 2000;15:680–686CrossRefPubMedGoogle Scholar
  7. 7.
    Auger J, Eustache F, Ducot B, Blandin T, Daudin M, Diaz I, El Matribi S, Gony B, Keskes L, Kolbezen M et al.: Intra- and inter-individuality variability in human sperm concentration, motility and vitality assessment during a workshop involving ten laboratories. Hum Reprod 2000;15:2360–2368Google Scholar
  8. 8.
    Cooper TG, Björndahl L, Vreeburg J, Nieschlag E: Semen analysis and external quality control schemes for semen analysis need global standardization. Int J Androl 2002;25:306–311CrossRefPubMedGoogle Scholar
  9. 9.
    WHO: WHO Laboratory Manual for the Examination of Human Semen and Semen-Cervical Mucus Interaction, 4th ed. Cambridge, UK, Cambridge University Press, 1999Google Scholar
  10. 10.
    WHO: WHO Laboratory Manual for the Examination of Human Semen and Semen-Cervical Mucus Interaction, 3rd ed. Cambridge, UK, Cambridge University Press, 1992Google Scholar
  11. 11.
    Jequier AM, Ukombe EB: Errors inherent in the performance of a routine semen analysis. Br J Urol 1983;55:434–436PubMedGoogle Scholar
  12. 12.
    Walker RH: Pilot surveys for proficiency testing of semen analysis. Arch Pathol Lab Med 1992;116:422–424Google Scholar
  13. 13.
    Carrell DT, Cornwell CE, Thorp C, Cartmill DC, Urry RL: Evaluation of a five year intra and interlaboratory semen analysis quality control program. Division of Urology, University of Utah School of Medicine, Salt Lake, 1987Google Scholar
  14. 14.
    Coetzee K, Kruger TF, Lombaard CJ, Shaughnessy D, Oehninger S, Ozgur K, Pomeroy KO, Muller CH, Muller C: Assessment of interlaboratory and intralaboratory sperm morphology readings with the use of a Hamilton Thorne Research integrated visual optical system semen analyzer. Fertil Steril 1999;71:80–84PubMedGoogle Scholar
  15. 15.
    Baker DJ, Paterson MA, Klaassen JM: Semen evaluations in the clinical laboratory. How well are they being performed? Lab Med 1994;25:509–514Google Scholar
  16. 16.
    Clements S, Cooke ID, Barrat CLR: Implementing comprehensive quality control in the andrology laboratory. Hum Reprod 1995;10:2096–2106PubMedGoogle Scholar
  17. 17.
    Johnson JE, Blackhurst DW, Boone WR: Can Westgard quality control rules determine the suitability of frozen sperm pellets as a control material for computer assisted semen analyzers? J Assist Reprod Genet 2003;20:38–45Google Scholar
  18. 18.
    Kvist U, Björndahl L: ESHRE monographs: manual on basic semen analysis. Oxford, UK, Oxford University Press, 2002Google Scholar
  19. 19.
    Davis RO, Gravance CG: Standardization of specimen preparation, staining, and sampling methods improves automated sperm-head morphometry analysis. Fertil Steril 1993;59:412–417PubMedGoogle Scholar
  20. 20.
    Ombelet W, Bosmans E, Janssen M, Cox A, Maes M, Punjabi U, Blaton V, Gunst J, Haidl G, Wouters E et al.: Multicenter study on reproducibility of sperm morphology assessment. Arch Androl 1998;4:103–114Google Scholar
  21. 21.
    Álvarez C, Castilla JA, Molina R, Ramírez JP, Vergara F, Yoldi A, Gaforio JJ: Biological variation in seminal parameters in healthy subjects. Hum Reprod 2003;18:2082–2088PubMedGoogle Scholar

Copyright information

© Springer Science + Business Media, Inc. 2005

Authors and Affiliations

  • C. Álvarez
    • 1
    • 5
  • J. A. Castilla
    • 2
  • J. P. Ramírez
    • 3
  • F. Vergara
    • 3
  • A. Yoldi
    • 3
  • A. Fernández
    • 3
    • 4
  • J. J. Gaforio
    • 1
  1. 1.Health Sciences DepartmentUniversity of JaénJaénSpain
  2. 2.Unit of Reproduction Hospital “Virgen de las Nieves,” GranadaSpain
  3. 3.Centro de Estudio e Investigación de la Fertilidad (CEIFER)GranadaSpain
  4. 4.Programa de Control de Calidad para Análisis de Semen de la Asociación para el Estudio de la Biología de la Reproducción (ASEBIR)MadridSpain
  5. 5.Departamento de Ciencias de la Salud, Área de EnfermeríaUniversidad de JaénJaénSpain

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