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Survey: WHO 5th Edition Standard for Semen Analysis
Background
This survey seeks to identify the current status of Andrology clinics attitude to the new WHO 5th Edition for Semen Analysis. It will part of a presentation for SIRT (Australia)in May 2011.
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1. The Question: Are you using WHO 5th edition in all aspects? -Results [n=50] Data=[Results: Yes= 19 No: 31 Total= 50] ANALYSIS
2. The Question: Have you largely implemented the WHO 5th with some exceptions? -Results [n=38] Data=[Results: Yes= 21 No: 17 Total= 38] ANALYSIS
3. The Question: Have you partially implemented the WHO 5th edition. -Results [n=31] Data=[Results: Yes= 13 No: 18 Total= 31] ANALYSIS
4. The Question: Have you not implemented the WHO 5th. -Results [n=27] Data=[Results: Yes= 8 No: 19 Total= 27] ANALYSIS
5. The Question: If you are not using WHO5, do you plan to move to it in the future? -Results [n=19] Data=[Results: Yes= 14 No: 5 Total= 19] ANALYSIS
6. The Question: Do you use a standard other than WHO4 or WHO5 eg ESHRE -Results [n=20] Data=[Results: Yes= 3 No: 17 Total= 20] ANALYSIS
7. The Question: Sample Volume is measured by marked centrifuge tubes -Results [n=24] Data=[Results: Yes= 7 No: 17 Total= 24] ANALYSIS
8. The Question: Sample Volume is measured by Pipetting. -Results [n=24] Data=[Results: Yes= 15 No: 9 Total= 24] ANALYSIS
9. The Question: Sample Volume is measured by weighing the sample (WHO5 recommended) -Results [n=21] Data=[Results: Yes= 5 No: 16 Total= 21] ANALYSIS
10. The Question: Haemocytometer used for counting sperm concentration -Results [n=25] Data=[Results: Yes= 12 No: 13 Total= 25] ANALYSIS
11. The Question: Makler chamber used for counting sperm concentration -Results [n=24] Data=[Results: Yes= 12 No: 12 Total= 24] ANALYSIS
12. The Question: Another chamber used for counting sperm concentration -Results [n=18] Data=[Results: Yes= 6 No: 12 Total= 18] ANALYSIS
13. The Question: Do you use the same process for IVF/ICSI/IUI samples as for Semen Analysis? -Results [n=25] Data=[Results: Yes= 20 No: 5 Total= 25] ANALYSIS
14. The Question: If you are not using a Haemocytometer, do you plan to move to it with WHO5? -Results [n=14] Data=[Results: Yes= 3 No: 11 Total= 14] ANALYSIS
15. The Question: Does your policy manual mandate that 200 spermatozoa be counted in each replicate? -Results [n=21] Data=[Results: Yes= 18 No: 3 Total= 21] ANALYSIS
16. The Question: Do your reports include reference to the total number of spermatozoa per ejaculate? -Results [n=24] Data=[Results: Yes= 21 No: 3 Total= 24] ANALYSIS
17. The Question: If you do not use a haemocytometer to estimate concentration, have you validated your method? -Results [n=13] Data=[Results: Yes= 8 No: 5 Total= 13] ANALYSIS
18. The Question: Do you visually assess motility -Results [n=21] Data=[Results: Yes= 19 No: 2 Total= 21] ANALYSIS
19. The Question: Do you use CASA to assess motility? -Results [n=20] Data=[Results: Yes= 2 No: 18 Total= 20] ANALYSIS
20. The Question: Do you assess grades as progressively motile,non-progressively motile and non motile WHO5)? -Results [n=21] Data=[Results: Yes= 15 No: 6 Total= 21] ANALYSIS
21. The Question: Do you assess motility as grades A,B,C,D (WHO4) -Results [n=17] Data=[Results: Yes= 8 No: 9 Total= 17] ANALYSIS
22. The Question: Do you assess 4 grade but report 3 grades of motility? -Results [n=18] Data=[Results: Yes= 5 No: 13 Total= 18] ANALYSIS
23. The Question: Does you policy manual require staff to assess at least 200 spermatozoa? -Results [n=20] Data=[Results: Yes= 19 No: 1 Total= 20] ANALYSIS
24. The Question: Do you asses motility at room temperature? -Results [n=23] Data=[Results: Yes= 19 No: 4 Total= 23] ANALYSIS
25. The Question: Do you assess motility at 37C? -Results [n=22] Data=[Results: Yes= 4 No: 18 Total= 22] ANALYSIS
26. The Question: Is the temperature for motility indicated on your reports. -Results [n=21] Data=[Results: Yes= 9 No: 12 Total= 21] ANALYSIS
27. The Question: Do you currently apply WHO5 morphology criteria and normal range? -Results [n=18] Data=[Results: Yes= 13 No: 5 Total= 18] ANALYSIS
28. The Question: Do you currently apply WHO4 criteria and normal range? -Results [n=15] Data=[Results: Yes= 4 No: 11 Total= 15] ANALYSIS
29. The Question: If you apply WHO4, are you planning to move to WHO5 standard in the near future? -Results [n=4] Data=[Results: Yes= 3 No: 1 Total= 4] ANALYSIS
30. The Question: Have you implemented WHO5 morphology ranges in your reports? -Results [n=17] Data=[Results: Yes= 12 No: 5 Total= 17] ANALYSIS
31. The Question: Have all staff been trained and certified for WHO5? -Results [n=16] Data=[Results: Yes= 10 No: 6 Total= 16] ANALYSIS
32. The Question: Are all staff under quality control to maintain competency? -Results [n=18] Data=[Results: Yes= 17 No: 1 Total= 18] ANALYSIS
33. The Question: Does your policy manual state that at least 200 spermatozoa must be counted? -Results [n=17] Data=[Results: Yes= 17 No: 0 Total= 17] ANALYSIS
34. The Question: Does your policy manual state that 2 slides are prepared and each used as a replicate [2.12.2] -Results [n=19] Data=[Results: Yes= 13 No: 6 Total= 19] ANALYSIS
35. The Question: Do you use Papanicolaou stain? -Results [n=17] Data=[Results: Yes= 2 No: 15 Total= 17] ANALYSIS
36. The Question: Do you use Shorr stain? -Results [n=18] Data=[Results: Yes= 1 No: 17 Total= 18] ANALYSIS
37. The Question: Do you use Diff-Quik stain? -Results [n=18] Data=[Results: Yes= 11 No: 7 Total= 18] ANALYSIS
38. The Question: Have you implented all the WHO5 reference ranges? -Results [n=18] Data=[Results: Yes= 12 No: 6 Total= 18] ANALYSIS
39. The Question: Have you partially/selectively implented all the WHO5 reference ranges? -Results [n=11] Data=[Results: Yes= 3 No: 8 Total= 11] ANALYSIS
40. The Question: Do you use the WHO4 (1999) reference ranges? -Results [n=14] Data=[Results: Yes= 3 No: 11 Total= 14] ANALYSIS
41. The Question: If you use the WHO4 (1999) reference ranges, are you planning to move to the WHO5 references ranges? -Results [n=3] Data=[Results: Yes= 2 No: 1 Total= 3] ANALYSIS
42. The Question: Have you implemented the new lower reference range for volume of 1.5 (1.4-1.7) mls -Results [n=16] Data=[Results: Yes= 12 No: 4 Total= 16] ANALYSIS
43. The Question: Have you implemented the new lower reference range for total number of 39 (33-46) /ejaculate -Results [n=17] Data=[Results: Yes= 11 No: 6 Total= 17] ANALYSIS
44. The Question: Have you implemented the new lower reference range for concentration of 15 (12-16)/ml -Results [n=17] Data=[Results: Yes= 14 No: 3 Total= 17] ANALYSIS
45. The Question: Have you implemented the new lower reference range for motility of 40 (38-42)% -Results [n=17] Data=[Results: Yes= 14 No: 3 Total= 17] ANALYSIS
46. The Question: Have you implemented the new lower reference range for morphology of 4 (3.0-4.0)% -Results [n=16] Data=[Results: Yes= 11 No: 5 Total= 16] ANALYSIS
47. The Question: Is your laboratory enrolled in an external EQA scheme -Results [n=16] Data=[Results: Yes= 14 No: 2 Total= 16] ANALYSIS
48. The Question: Do you perform Internal QC for concentration? -Results [n=16] Data=[Results: Yes= 15 No: 1 Total= 16] ANALYSIS
49. The Question: Do you perform Internal QC for motility on every staff member? -Results [n=16] Data=[Results: Yes= 14 No: 2 Total= 16] ANALYSIS
50. The Question: Do you perform Internal QC for morphology on every staff member? -Results [n=15] Data=[Results: Yes= 12 No: 3 Total= 15] ANALYSIS
51. The Question: Do you have a training program for assessing the competency for new staff? -Results [n=16] Data=[Results: Yes= 16 No: 0 Total= 16] ANALYSIS
52. The Question: Do you have a ongoing assessment program for assessing the competency for current staff? -Results [n=14] Data=[Results: Yes= 14 No: 0 Total= 14] ANALYSIS
53. The Question: If so, is this at least performed annually? -Results [n=14] Data=[Results: Yes= 14 No: 0 Total= 14] ANALYSIS
54. The Question: I am a dedicated Andrology Laboratory -Results [n=14] Data=[Results: Yes= 5 No: 9 Total= 14] ANALYSIS
55. The Question: I am an Andrology/IVF Laboratory -Results [n=14] Data=[Results: Yes= 10 No: 4 Total= 14] ANALYSIS
56. The Question: I am a Pathology Laboratory -Results [n=12] Data=[Results: Yes= 0 No: 12 Total= 12] ANALYSIS
57. The Question: I have 3 or fewer staff performing Andrology -Results [n=15] Data=[Results: Yes= 9 No: 6 Total= 15] ANALYSIS
58. The Question: I have 4-6 staff members performing Andrology assessments -Results [n=15] Data=[Results: Yes= 4 No: 11 Total= 15] ANALYSIS
59. The Question: I have more than 6 staff performing Andrology assessments -Results [n=15] Data=[Results: Yes= 3 No: 12 Total= 15] ANALYSIS
60. The Question: My lab has been accredited to perform Semen Analysis -Results [n=16] Data=[Results: Yes= 14 No: 2 Total= 16] ANALYSIS
Comments
#1 of Australia writes: Does No Reply mean Not Applicable or don't want to reply?
#2 of Australia writes: My comments disappeared? Again. Weighing by preference but if pot not pre-weighed then by pipette. You do not have this option.
#3 of Australia writes: Comment is made on the report form about our choice to use rapid motility against WHO5 as a validated discriminating parameter
#4 of Australia writes: reference range not normal range!
#5 of Australia writes: we also have comments regarding the refeerence ranges in our reports
#8 of Australia writes: we believe in our hands that rapid (WHO4) remains a useful discriminating variable
#9 of Australia writes: this bit lost for the third time so there is a bug somewhere- I said we preferably use WHO5 weight but if pots not pre-weighed then pipette volume is used as per WHO4
#11 of Australia writes: Our major obstacle to early implementation of the WHO 5th Ed is being dependent upon our IVF database supplier (Genie) in updating the new reference values that appear on the SFA report template.
#12 of Australia writes: At least 200 spermatazoa be counted
#13 of Australia writes: Sydney IVF has completed the transition to WHO 5th edition. This process took us appoxiantely 9 months to complete. The impact on the lba has been quite extensive as the 5th requires a lot of repetition of counts, resetting of samples and a lot of error and other compliacted calculations. However, overall it does appear that the methods give a much more accurate and repeatable result and one that we can present to doctors as the closest to a "true" value.
#14 of Australia writes: We continue to assess rapid and slow progressive. We report all four categories (as our doctors have indicated they prefer this) but only give a lower reference limit for progressive as a total. We only assess washed motility on CASA. this has been validated.
#15 of Australia writes: Sydney IVF has always used Tygerburg strict criteria, so this was an easy change for us to make.
#16 of Australia writes: On our semen analysis reports we have listed the normal parameters as per WHO 5th edition.
#17 of Australia writes: This is from City Fertility Centre Adelaide, Emma has asked us to respond on an individual clinic basis... so this is us.... fully implemented 5th edition. Hope all is well Jim, speak to you soon Cheryl
#18 of Australia writes: Our lab also emphasises on the motile sperm per ml along with the percent morphology for each male, as this is very important basis to interpret the results.
#19 of Australia writes: To measure volume by weight is quite variable and is highly dependent on the density of the sample. Each semen sample has a different density and we have observed significant variations from sample to sample when volume is measured by two different methods.
#20 of Australia writes: All the staff in my lab apply the same method to count the sperm from each grid, which is according to the new WHO5 is counting the sperm that lies on the lower or left centre boundaries, which form an L shape.
#21 of Australia writes: We initially estimate the motility and then do the count. The count should be close to our estimate, which gives more accuracy to the assessment.
#22 of Australia writes: WHO5 there is not much incuded in this manuals.
 
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