EVALUATION OF COMPUTER-ASSISTED SEMEN ANALYSIS (CASA) WITH IDENT STAIN TO DETERMINE SPERM CONCENTRATION

This study was undertaken to compare a new fluorescent stain-based com puter-assisted semen analysis (CASA) system (IDENT) for determining hu man sperm concentration to the manual hemacytometric method and to con ventional CASA (CASA-CONV). Normal healthy semen donors as well as pat ients provided samples that were evaluated for sperm concentration wit h the CASA-IDENT method, the hemacytometer method and CASA-CONV. Each field was examined visually to determine the sources of overcounting a nd undercounting for the two CASA methods;four ranges of sperm concent ration were examined: 0-10, > 10-30, > 30-100, and > 100 x 10(6)/ml. T he main outcome measures were sperm concentration, debris counted as s perm, and missed sperm. Our results showed that significantly more deb ris was counted as sperm and more sperm were missed with CASA-CONV tha n CASA-IDENT. As the sperm density increased, so did the number of cou nting errors for the CASA-CONV system. The error rate was much greater using CASA-CONV (12.1 +/- 42.2%) than with CASA-IDENT (0.4 +/- 0.7%) when compared to hemacytometer counts (P = 0.068). We conclude that th e CASA-IDENT method of sperm counting is highly accurate and less time -consuming when compared to the hemacytometer method. There are signif icant differences in the amount of debris counted as sperm and number of missed sperm between CASA-CONV and CASA-IDENT with varying sperm de nsity. With both parameters, the counts are more accurate using the CA SA-IDENT method.