MULTICENTER STUDY ON REPRODUCIBILITY OF SPERM MORPHOLOGY ASSESSMENTS

Sperm morphology has always been considered an important tool in evalu ating a man's fertilizing potential. The objective of this multicentri c study was to evaluate intra- and interindividual variability and bet ween-laboratory variation using the same or different criteria of sper m morphology assessment. Semen samples were obtained from 20 males and 32 smears were made of all samples. Eighty coded smears (4 per patien t) were sent to 8 laboratories for morphology assessment. The centers applied different classification systems (strict criteria, WHO 1987, D usseldorf criteria) and participants were asked to analyze the 80 smea rs twice, with an interval of 1 week between each participant's two an alyses. Intraclass correlations between repeats showed that sperm morp hology can be assessed with acceptable within observer reproducibility . Expected increases in imprecision were observed up to coefficients o f variation of >30% with decreasing morphology scores, regardless of t he classification system used. Agreement in correct classification of samples as normal/abnormal was obtained in 80% of cases. Differences i n reproducibility between slides may reflect an important source of he terogeneity due to smear preparation. These results emphasize the impo rtance of external quality control systems to improve the value of spe rm morphology assessments in the investigation of the male partner in a subfertile couple.