CAP TODAY Pathology/Laboratory Medicine/Laboratory Management
CAP Press released late last year its Semen Analysis Benchtop Reference Guide, an illustrated guide with emphasis on sperm morphology. Its 68 laminated pages are divided into sections: specimen collection and macroscopic assessment, sperm count, sperm morphology, and nonsperm cells.
Dr. Nelsen
Behind the book is the CAP Reproductive Medicine Committee, in particular Erica J. Behnke, PhD, HCLD, of Ohio Fertility Providers, Jacob F. Meyer Jr., PhD, HCLD, of Eastern Virginia Medical School, and Laura L. Nelsen, MD, pathologist and director of cytology at MaineGeneral Medical Center and past chair of and now advisor to the committee. CAP TODAY asked Dr. Nelsen about the benchtop reference guide, sample pages of which appear below. Here is what she told us.
Who are the intended readers of the reference guide and how will it be of use to them?
March 2019—This reference guide is aimed at laboratory technicians and scientists, either working in a reproductive laboratory or general clinical laboratory and seeking assistance on performing semen analysis. Currently, the CAP accredits 343 reproductive laboratories (of 465 registered by CMS), with many of those labs offering semen analysis. Many general labs and some urologists also offer this test to patients, which can be fraught with subjective variation, especially in the qualitative components, such as semen morphology or viability. This test is classified as high complexity by CLIA ’88, making it subject to various QA and QC requirements.
Interestingly, many people do not know about the strong collaboration between the CAP and reproductive laboratories. When I have attended the CAP Council on Scientific Affairs meetings, I usually meet at least one pathologist serving as a committee chair who is surprised to learn of our committee’s existence, as most reproductive medicine is assumed to be under the purview of obstetrical medicine and the Society for Assisted Reproductive Technology. The field of reproductive medicine is relatively young, however, and the CAP has long set the standard for lab accreditation and good practices. When commercial reproductive labs took off in the 1990s, a collaboration between our societies was formed.
How does this book differ from others on the market?
When our group was exploring the need for this reference guide, we searched for comparable benchside publications and had difficulty finding any currently available. For the majority of labs, the gold standard in analysis is the WHO laboratory manual for the examination and processing of human semen. The most current edition, the fifth, was published in 2010. Our book generally follows the WHO recommendations but as an abbreviated, illustrated guide. The WHO publication offers a comprehensive and detailed guide for performing and interpreting semen analysis, and while we recommend it to all our labs, it can be unwieldy to use on a day-to-day basis. Additionally, with more than 20 years of proficiency testing challenges, our committee had a rich library of images to draw from, to illustrate normal and abnormal spermatozoa. The large images on laminated pages that can be beside the microscope are an important tool in practice and training.