Computer-aided evaluation of assessment of “grade a” spermatozoa by experienced technicians

ObjectiveTo determine how well technicians assess progressively motile spermatozoa.DesignComparison of computerized and technician assessments of “grade a” spermatozoa.SettingUniversity fertility clinic.Patient(s)Infertile men of barren marriages.Intervention(s)None.Main Outcome Measure(s)Threshold velocities of spermatozoa categorized as “grade a.”Result(s)The ability of andrology technicians to distinguish “grade a” from “grade b” spermatozoa was examined monthly. Computer-aided sperm analysis (CASA) provided the threshold velocities used by technicians to categorize “grade a” spermatozoa. The mean cutoff value for grades a/b (25.5 μm/s) was close to the designated velocity, but the cutoff for grades b/c sperm (9.9 μm/s) was higher. Cutoff values for “grade a” spermatozoa were significantly, positively, and linearly related with the mean velocity of spermatozoa obtained by CASA, and deviated from it in a systematic way. The percentage of “grade a” spermatozoa judged by technicians was poorly correlated with the percentage “grade a” indicated by CASA and the cutoff velocity of “grade a” spermatozoa depending on the overall sperm quality of the semen sample.Conclusion(s)Consideration should be given to replacing the subdivision of progressing spermatozoa into two categories with one of progressive spermatozoa, or the use of CASA to distinguish “grade a” sperm reliably should be insisted upon.