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Murong Xu^1,2, Mingpeng Zhao^1,3, Huixia Yang¹

¹Assisted Reproductive Technology Unit, Department of Obstetrics and Gynaecology, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China.

|February 10, 2025

概括

计算机辅助精子分析 (CASA) 系统与手动方法相比显示出不一致的结果,特别是在精子形态方面. 目前的CASA系统无法取代手动分析来诊断男性不孕症,需要进一步改进.

科学领域:

安德罗学与人类学
生殖医学生殖医学
医学实验室科学医学实验室科学

背景情况:

手动精液分析至关重要,但劳动密集型和主观.
计算机辅助精子分析 (CASA) 系统旨在提高效率和客观性.
对于CASA结果与手工方法的一致性,特别是对于男性不孕症诊断,仍然不清楚.

研究的目的:

为了比较三个CASA系统 (汉密尔顿-索恩CEROS II,LensHooke X1 Pro,SQA-V Gold) 与手动精液分析方法的一致性.
评估CASA系统在诊断男性不孕症状况中的表现,例如小精子症,精子症和三精子症.

主要方法:

在2020年1月至2020年10月期间,共招募了326人.
手动精液分析是黄金标准.
在CASA系统和手动方法之间使用类内相关系数 (ICC) 和kappa统计数据进行了对对比.

主要成果:

在精子度方面,LensHooke X1 Pro表现最好 (ICC=0.842),而CEROS II (ICC=0.723) 和SQA-V Gold (ICC=0.631) 则表现中等.
机动性分析显示,与CEROS II (ICC=0.634) 的一致性适度,但与LensHooke (ICC=0.417) 和SQA-V Gold (ICC=0.451) 的一致性较差.
形态分析缺乏与手册结果的一致性 (LensHooke ICC=0.160,SQA-V金 ICC=0.261). CASA系统倾向于偏好传统的试管婴儿而不是ICSI,这可能会扭曲治疗分配.

结论:

目前的CASA系统与手动精液分析显示出可变一致性,在运动性和形态学方面存在显著差异.
手动方法仍然是andrology实验室不可或缺的;经过测试的CASA系统目前无法取代它.
对CASA算法的改进,特别是对形态的改进,是必要的,并且在等待进一步验证之前,应谨慎解释结果.

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