Monitoring technologist reading skills in a sperm morphology quality control program

Objective: The value of sperm morphology as a predictor of a man's fertilizing potential has often been challenged because of different classification systems used to distinguish between normal and abnormal spermatozoa. The study aimed to monitor the reading skills of 53 laboratory technologists who are enrolled in a continuous quality control program for sperm morphology assessment. Design: Prospective analytical study. Setting: Academic hospital and academic institution setting. Patient(s): Sperm samples from the sperm donor program and andrology technicians from sub-Saharan Africa. Intervention(s): Papanicolaou-stained sperm slides were prepared and shipped on a quarterly basis to participating laboratories. Papanicolaou-prestained sperm morphology slides were used as test material for 21 months. Main Outcome Measure(s): Percentage normal spermatozoa. Result(s): A new statistical model was developed to record reading skills of the participating technicians. Reading skills were classified as marginal (5.7% of cases), good (11.3% of cases), and excellent (83% of cases). Participants maintained their morphological reading skills and agreed with the reference laboratory by not exceeding a SD limit of 0.2 to set stringent standards for the program. Conclusion(s): Technician proficiency can be monitored using the results of a quality control program. A continuous quality control program can be initiated only after intensive training, because baseline values at the onset of the quality control program serves as an internal reference value.