Andrology Laboratory Update - Abstract
Background: Increasing availability to assisted reproduction (AR) treatments and advances in cryobiology, mainly oocyte vitrification, modified andrology laboratories performance. On the other hand, environmental and lifestyle factors seem to have a deleterious effect on semen quality. Aim: To evaluate the demand and evolution of seminal parameters in the last two decades, characterize the current andrology laboratory and assess its improvement after computer-assisted systems (CASA) inclusion and to appraise the adherence to quality assurance procedures. Materials and methods: Data from 22,528 semen analysis from patients attending the Laboratory of Male Fertility at the Buenos Aires University Clinical Hospital “José de San Martín”, were analyzed. Information regarding Semen Analysis External Quality Control Schemes (EQCS) in Argentina is reported. Results: Overall demand decreased significantly while first-time ordered increased. Sperm volume and sperm count, androgen dependent parameters, went down over the years. Strict morphology criteria decreased the percentage of normal sperm. The CASA system allowed objectifying sperm kinetics, increasing the percentage of fast progressive sperm (Ga). The number of participant laboratories in Semen Analysis EQCS was 62 and 146 at present. Only four laboratories became accredited. Clinical Translation: Male fertility could be at risk. Strengths and Limitations: Two decades spermiograms results were recorded. The reported data are limited to Argentine. Conclusions: The Andrology Laboratory demand decreased due to an increase in AR treatments. Either sperm count or semen volume diminished over time. The decrease in the percentage of normal forms endangers its clinical value. Objective motility improves the assessment of kinetic parameters. Adherence to External Quality Programs improved although there are still very few accredited Andrology Laboratories.