The continued existence of significant disparities in the technical practices of sperm morphology assessment and the clinical implications: results of a French questionnaire

Objective To investigate current practices for sperm morphology assessment. Design E-mail survey questionnaire. Setting Diagnostic and clinical institutions/laboratories. Patient(s) French biologists and clinicians (n = 225). Intervention(s) None. Main Outcome Measure(s) Answers to 24 questions. Result(s) The survey shows that even now in France there is great inconsistency in the use of sperm morphology assessments. For example, the survey revealed that no fewer than six different staining techniques were in use. Automatic reading is hardly used (used by 2.5% of the biologists replying to the survey). More than 33.6% of biologists use a threshold of normal forms unsuited to their classification, and 20% do not perform any internal quality control in this area. Prescribing doctors seldom trust the tests, likely due to their lack of analytic reliability. Among the biologists surveyed 26% said the percentage of normal forms is either unreliable or not very reliable in analytic terms, and 24% of clinicians stated that it has little clinical relevance. Conclusion(s) The survey reveals a marked lack of uniformity in French laboratories for performing sperm morphology assessment and in the use of the results by physicians. Regular quality control procedures and well-trained personnel, up to date with their training and conversant with the latest techniques as well as harmonized practices, are clearly indispensable. It is time for a consensus on the practice and interpretation of this particular test.