Comparison between a new device for the semen quality analysis and the manual microscopic evaluation in a not specialistic clinical laboratory

Objectives: Semen analysis investigates different parameters of human semen with a high relevance in fertility workup, confirmation of sterility by post vasectomy, in pathologies follow-up such as varicocele and in all cases where sperm preservation is required. Manually seminal fluid examination is characterized by poor reproducibility. Aim of this study was to evaluate the performance of an automatic device in semen analysis by comparing its results with those obtained with the manual microscopy.

Materials: Fifty samples (age 18-59 years) were analyzed simultaneously by the manual and automated method. Manual analysis was performed by at least two experienced operators. Concentration and motility were determined by means of standard manual analysis and by the automated LensHooke™ analyzer following the last WHO guidelines.

Results: We compared the concentration (million/mL) of spermatozoa obtained from manual and instrumental count and different classifications obtained: normal, oligospermic, cryptospermic and azoospermic samples. The Wilcoxon test does not show a statistically significant difference. The Bland-Altman plot showed a slightly higher value for the manual count. Second, we compared the morphology and the samples classification in morphological normal and abnormal. Third, spermatozoa motility obtained from the manual and instrumental count was compared with a different classification in normal total motility and asthenozoospermia. Statistical tests showed respectively for morphology and motility a moderate and a very good agreement.

Conclusions: Our study demonstrates that the LensHooke™ shows an acceptable agreement with the manual microscopic seminal fluid evaluation. The use of this simple device could help to standardize reports in non specialistic laboratories.