Can Westgard Quality Control Rules determine the suitability of frozen sperm pellets as a control material for computer assisted semen analyzers?

Accu-Beads as a quality control measure for manual and automated methods of measuring sperm concentration-an observational study

PURPOSE

To determine the precision and accuracy of Accu-Beads and their utility as a quality control product for manual and automated measurements of sperm concentration.

METHODS

This observational study was performed at an Assisted Reproductive Technology laboratory in a tertiary-care, university hospital. To simulate sperm concentration, bead concentrations were measured with the use of a manual and an automated method.

RESULTS

The manual counts did not vary significantly from the automated counts regardless of the concentration. However, the counts did vary between lots of low concentration of Accu-Beads and between the two different types of fixed counting chambers. The two bead concentrations used in this study were below the 95 % confidence interval for the values listed by the manufacturer.

CONCLUSION(S)

In our laboratory, Accu-Beads met enough of the requirements of a good control material to be acceptable for daily quality control use, especially if we set our own ranges of acceptability for each vial of Accu-Beads. It is necessary to evaluate each new lot of Accu-Beads when they are received and again if they are used with a different counting chamber.

Quality Management Issues in the Assisted Reproduction Laboratory

In the United States, the Clinical Laboratory Improvement Act (CLIA) of 1988 describes requirements and guidelines for implementing a quality control/quality assurance (QC/QA) program for moderate and high complexity laboratories. These requirements and guidelines apply to Assisted Reproductive Technology (ART) laboratories as well. The general topic of QC and QA as it pertains to in vitro fertilization (IVF) and embryo transfer (ET) is extensively reviewed. This review summarizes many of the QC and QA events that contribute to the advancement of knowledge in this biotechnological field. These events include control of the culture environment inside and outside of the incubator, as well as factors that affect culture media. This review also discusses, in considerable detail, the QC and the QA that pertain to equipment used within the laboratory and how to control for potential contaminants, which reside within the laboratory. This review provides evidence to indicate the need for laboratory personnel to monitor quality improvement issues on a continuous basis. Personnel must be willing to change as improvements in technology occur in order to meet the ever-evolving demands of a more difficult patient population. Suggestions for meeting these demands are offered.

Procedure control and acceptance sampling plans for donor sperm banks: a theoretical study

The publication of European Directive 2004/23/EC in the European Parliament and in the European Council on 31 March 2004 concerning the setting of standards of quality and safety for the donation, procurement, testing, processing, preservation, storage and distribution of human cells and tissues made it obligatory for sperm banks to set up quality control systems to ensure, among other goals, the satisfactory control of all procedures carried out. The objective of the present study is to set out guidelines that will make it possible to ensure the quality of the donors and frozen specimens accepted and the homogeneity of the samples supplied by a sperm bank. For this purpose, we shall describe clear-cut criteria for the acceptance of donors and frozen sperm, taking into account both analytic variability and the biological variations to be expected in semen parameters. Furthermore, we shall show how the evaluation of the results of a frozen semen specimen, on the basis of analysing a single straw after such freezing, does not guarantee the homogeneity of all the straws. Therefore, we must design a sampling plan to take into consideration all the straws obtained from a donor. This kind of plan will depend on different parameters, such as acceptable levels of quality and the tolerable rate of straws with defective semen, and will involve certain risks, both for the sperm bank and for the client. The establishment of these acceptance control criteria for frozen specimens and for donors could be of practical use for the control of the procedures applied in the operation of a sperm bank.

External quality control program for semen analysis: Spanish experience

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.