A continuous quality control program for strict sperm morphology.

OBJECTIVE: To develop a training program with intervals of continuous quality control assessments for the evaluation of strict sperm morphology.
DESIGN: Prospective analytical study.
SETTING: Academic hospital and academic institution setting. PATIENT(S): Healthy sperm donors. INTERVENTION(S): Nine individual andrology laboratories in Switzerland were invited to participate in a training course for strict sperm morphology, which was followed up every 3 months by a continuous quality control program. Each laboratory received six slides over a period of 9 months, during which time the results were forwarded to the reference laboratory. Papanicolaou stain sperm slides were prepared and shipped to participating laboratories every 3 months. MAIN OUTCOME MEASURE(S): Percentage of normal spermatozoa. RESULT(S): The mean (+/-SE) percentage of normal sperm reported by the reference laboratory compared with the participating laboratories for slides 1-6 were 11. 4 +/- 1.6 vs. 17.3 +/- 6 (P>.2), 6.0 +/- 1.3 vs. 8.6 +/- 2.5 (P>.2), 9.0 +/- 0 vs. 9.6 +/- 3 (P>.2), 1 +/- 0 vs. 1.2 +/- 0.2 (P>.2), 23.3 +/- 0.3 vs. 28.0 +/- 1.3 (P>.2), and 2.0 +/- 0 vs. 6.1 +/- 1.2 (P>.2), respectively. Technician proficiency was reported to differ by <10% from the reference laboratory in 94% of cases. CONCLUSION(S): The results illustrate that training and proficiency testing can be conducted on a national and international level with the support of a reference laboratory. Global quality control measurements in andrology laboratories should become mandatory, since these results indicate that continuous quality control for laboratory technicians can be successful.