INTRAOBSERVER, INTEROBSERVER VARIATION OF SPERM CRITICAL MORPHOLOGY -COMPARISON OF EXAMINER AND COMPUTER-ASSISTED ANALYSIS

Objective: To examine intraobservational and interobservational variat ion in sperm critical morphology analysis between trained andrologists and a computer over the range of 0% to 15% normal forms. Design: Retr ospective. Setting: Fertility center. Patients: Twenty-four semen spec imen slides were read five times in a randomized, blinded fashion by t wo andrologists and a computerized semen analyzer. Twenty-five samples were analyzed using a different stain and a centrifugation step. Main Outcome Measure: Sperm strict morphology. Results: Mean average intra observer deviation of normal forms was small (1.3% to 2.7%). Intraobse rver deviation did not differ between andrologists, but both differed from the computer. Interobserver variation for percent normal forms wa s similar for andrologists and computer. Mean average deviations were small over the entire range of normal forms (<3%), there were no diffe rences between examiners, and the variation was independent of the ini tial percent normal forms. The computer frequently evaluated significa ntly fewer cells than the andrologists. Updated software increased the number of cells read by the computer requiring more time than the and rologist. Conclusions: Trained andrologists and a computer determine s perm critical morphology similarly over the range of 0% to 15% normal forms. A single evaluation is highly predictive of multiple evaluation s. Improvements in the speed of computer assessment are still necessar y.