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Lessons learned from a sperm morphology quality control programme

Although sperm morphology is the sperm parameter that is consistently correlated with in vitro and in vivo fertilisation, its value is often challenged due to discrepancies in reports. As sperm morphology is subjectively evaluated, the outcome of the report is entirely based on the experience and technical skill of the laboratory technician responsible for semen analyses. The study aimed to record the value of quarterly monitoring and refresher courses on morphology reading skills of technicians over a period of 40 months. Nineteen individuals from 12 different andrology laboratories were enrolled to a sperm morphology quality control programme after initial training sessions. Five of the 19 participants attended annual refresher courses. Two limits of error, namely ± 0.5 SD and ± 0.2  SD scores, were used to record technician deviation from the reference laboratory. Fifteen of the 19 individuals (78%) consistently reported sperm morphology readings that were within the ± 0.5 SD limits of error. Furthermore, five of the participants, who attended annual refresher training courses, consistently reported results that were within the ± 0.2 SD limits of error. For the first time, it has been illustrated that excellent sperm morphology reading skills can be achieved and maintained by initial training sessions, followed up with a continuous external quality control programme and annual refresher courses.