Determining sample size for the morphological assessment of sperm.

Morphologic assessment of spermatozoa is an integral component in the analysis of semen. Whether a technician rapidly screening semen quality at a commercial stud, a veterinarian performing breeding soundness examinations, a clinician at a reference andrology laboratory providing auditing or diagnostic services, or a researcher evaluating morphology as a part of a fertility study, it is important to make an informed decision regarding the number of spermatozoa to include in the morphology assessment. Application of basic statistical principles such as the nature of proportions, level of confidence in an observed value, and the interaction of sample size with precision, can and should be used in the decision process. This paper outlines in detail the application of these statistical principles in relation to the morphologic assessment of spermatozoa. Guidelines on how these principles can be utilized in practical situations are discussed. Additionally, methodologies for comparison of results within and between laboratories (an area easily prone to misinterpretation) are reviewed. It is hoped that through the use of these fundamental statistical principles, this paper will bring clarity and delineation to the science of quantifying the morphology of spermatozoa.