The development of a continuous quality control programme for strict sperm morphology among sub-Saharan African...

Area of Science:

• Reproductive Medicine
• Andrology
• Laboratory Quality Control

Background:

• Inter-technician and inter-laboratory variability in sperm morphology evaluation is a significant concern.
• Standardized and accurate semen analysis is crucial for male fertility assessments.

Purpose of the Study:

• To develop and evaluate an intensive training program with continuous quality control for sperm morphology assessment.
• To reduce variability in sperm morphology evaluations across different laboratories.

Main Methods:

• Twenty andrology laboratories in sub-Saharan Africa participated in a World Health Organization (WHO) semenology workshop.
• Intensive training in strict sperm morphology evaluation was followed by quarterly quality control assessments.
• Sperm morphology results were compared against a reference laboratory.

Main Results:

• The mean percentage difference between participants and the reference laboratory decreased from 33.5% at baseline to 14.3% at 3 months and 5.0% at 6 months post-training.
• Pre-training differences were statistically significant compared to 3-month and 6-month post-training differences (P = 0.0002 and P = 0.007, respectively).
• No significant difference was observed between 3-month and 6-month results (P = 0.27), indicating sustained improvement.

Conclusions:

• Intensive training and continuous quality control are effective in improving sperm morphology assessment accuracy.
• National and international training and proficiency testing programs are feasible with reference laboratory support.
• Mandatory global quality control in andrology laboratories is recommended to ensure consistent and reliable results.