The development of a continuous quality control programme for strict spermmorphology among sub-Saharan African laboratories

Inter-technician and between-laboratory differences, especially during the evaluation of sperm morphology, have been a major cause of concern. The stu dy aimed to develop an intensive training programme with intervals of conti nuous quality control assessments for sperm morphology, Twenty andrology la boratories from sub-Saharan Africa were invited to participate in a World H ealth Organization Special Programme of Research, Development and Research Training in Human Reproduction semenology workshop. Following intensive, tr aining in strict sperm morphololgy evaluation, a continuous quality control programme was introduced on a quarterly basis. At baseline, the mean (+/- SD) percentage difference reported between the participants and the referen ce laboratory reading was 33.50 +/- 11%. After training, the mean percentag e difference had decreased to 14.32 +/- 5% at 3 months and to 5.00 +/- 5% a t 6 months. Pairwise comparison of the differences at each evaluation time revealed the following: Baseline differences (pre-training) differed signif icantly from the differences at 3 months (P = 0.0002) as well as at 6 month s after training (P = 0.007). The differences at 6 months did not differ si gnificantly from those at 3 months (P = 0.27). Training of andrology techni cians as well as continuous proficiency nesting can be conducted on a natio nal and international level with the support of a referring laboratory. Glo bal quality control measurements in andrology laboratories should become ma ndatory, since these results indicate that continuous quality control for l aboratory technicians ran be highly successful.