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Hum. Reprod. Advance Access originally published online on July 8, 2005
Human Reproduction 2005 20(11):2983-2986; doi:10.1093/humrep/dei189
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© The Author 2005. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved. For Permissions, please email: journals.permissions@oupjournals.org

DEBATE CONTINUED

Debate—continued

Is quality assurance in semen analysis still really necessary? A spermatologist’s viewpoint

W.V. Holt

Institute of Zoology, Zoological Society of London, Regent’s Park, London NW1 4RY, UK

E-mail: bill.holt{at}ioz.ac.uk

In a provocative article to this Journal, Anne Jecquier, an eminent andrologist who, more than 20 years ago, was a prime mover in suggesting the need for quality assurance (QA) in andrology laboratories, has now proposed that the QA schemes may no longer be needed. Here I reply to that proposition, largely by agreeing that, since the QA schemes have brought about higher technical standards in laboratories, Anne Jecquier’s assertion is possibly true. However, vigilance is still needed in discriminating between unproductive investment of time and energy in the refinement of tests that may offer little information about fertility, and maintaining technical standards such that where necessary they provide the requisite information. Thus, although it may not matter in practice whether a sperm concentration is estimated as 100 or 200 x 106/ml, distinguishing between 25 and 100 x 106/ml would probably influence a clinician’s treatment decisions. Anne Jecquier also suggested that sperm function tests have limited predictive value in terms of fertility assessment. While I agree that this is largely true at present, I also argue that these tests are probably not developed to their full potential. I am optimistic that tests to distinguish and quantify the population of fertilization-competent sperm within an ejaculate will eventually become available.

Key words: functional tests/quality assurance/semen analysis/sperm subpopulations


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