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Agarwal A, Panner Selvam MK, Ambar RF. Validation of LensHooke® X1 PRO and Computer-Assisted Semen Analyzer Compared with Laboratory-Based Manual Semen Analysis. World J Mens Health 2021; 39:496-505. [PMID: 33663026 PMCID: PMC8255407 DOI: 10.5534/wjmh.200185] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Revised: 12/16/2020] [Accepted: 01/02/2021] [Indexed: 12/24/2022] Open
Abstract
Purpose To compare two automated semen quality analysis systems (LensHooke® X1 PRO [X1 PRO]) and IVOS CASA) for accuracy, precision and agreement with laboratory-based manual semen analysis (MSA). Materials and Methods Semen samples (n=31) were obtained from normozoospermic healthy male volunteers and infertile men with a minimum abstinence period between 2–3 days. After complete liquefaction, 101 seminal aliquots were prepared and tested according to WHO 5th Edition (2010) guidelines. The results obtained by X1 PRO and IVOS CASA were compared with that of MSA. Additionally, 10 samples were used to evaluate the intra- and inter-rater agreement for X1 PRO and MSA. Results The semen parameters (sperm concentration, total, and progressive motility) showed strong correlation and agreement for both automated semen analyzers and MSA (Spearman's rank correlation ≥0.92, p<0.0001). X1 PRO and IVOS CASA were able to differentiate samples with abnormal concentration with a positive predictive value (PPV) of 100%. Furthermore, the PPV for X1 PRO (86.5%) was higher than that for IVOS CASA (71.7%) in differentiating samples with abnormal motility. The X1 PRO device showed a high PPV (97.7%) in identifying normal sperm forms compared to MSA. Semen parameters evaluated showed a high inter-rater (kappa >0.91) and intra-rater (kappa >0.92) agreement for X1 PRO compared with MSA. Conclusions Both automated semen analyzers demonstrated a high level of concordance and their performance was comparable with MSA analysis. Furthermore, high-levels of inter-and intra-rater reliability for semen analysis indicate that the new X1 PRO can be used in a clinical laboratory to offer accurate and quick test results.
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Affiliation(s)
- Ashok Agarwal
- American Center for Reproductive Medicine, Cleveland Clinic, Cleveland, OH, USA.
| | | | - Rafael F Ambar
- American Center for Reproductive Medicine, Cleveland Clinic, Cleveland, OH, USA.,Urology Department of Centro Universitario em Saude do ABC/Andrology Group at Ideia Fertil Institute of Human Reproduction, Santo André, Brazil.,Hope Clinic-Human Reproduction, São Paulo, Brazil
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Lammers J, Chtourou S, Reignier A, Loubersac S, Barrière P, Fréour T. Comparison of two automated sperm analyzers using 2 different detection methods versus manual semen assessment. J Gynecol Obstet Hum Reprod 2021; 50:102084. [PMID: 33545411 DOI: 10.1016/j.jogoh.2021.102084] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Revised: 01/15/2021] [Accepted: 01/28/2021] [Indexed: 12/21/2022]
Abstract
PURPOSE The exploration of male infertility is mainly based on semen analysis, but its evaluation might be affected by the operator's competence and subjectivity. This led to the development of automated semen analyzing systems. Despite continuous improvement, the precision and correlation of these automated systems with manual sperm assessment performed strictly according to WHO guidelines remains variable in the literature, and their role in daily practice is debated. METHODS In this double blind prospective study, we compared the results provided by 2 automated systems based on different concepts (CASA and electro-optical signal) with manual sperm assessment. Sperm concentration, motility and morphology were performed simultaneously and independently by different operators, blinded to each other. RESULTS A total of 102 unselected men attending the andrology department for routine sperm analysis were included in the study. We found no significant difference between each automated method and manual assessment for all sperm parameters, except for sperm morphology assessment where the electro-optical system gave higher results and performed slightly poorer than CASA. Correlation was moderate to high between manual assessment and each automated methods for all sperm parameters, with randomly distributed differences. CONCLUSIONS Overall, these results show that both types of automated systems can be implemented in andrology laboratory for routine sperm analysis.
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Affiliation(s)
- Jenna Lammers
- CHU Nantes, Nantes Université, Service de biologie et médecine de la reproduction, Nantes, France; Nantes Université, Inserm, Centre de Recherche en Transplantation et Immunologie, UMR 1064, ITUN, Nantes, France
| | - Sana Chtourou
- CHU Nantes, Nantes Université, Service de biologie et médecine de la reproduction, Nantes, France; Laboratoire de biologie de la reproduction et de cytogénétique, Hôpital Aziza Othmana, Tunis, Tunisia
| | - Arnaud Reignier
- CHU Nantes, Nantes Université, Service de biologie et médecine de la reproduction, Nantes, France; Nantes Université, Inserm, Centre de Recherche en Transplantation et Immunologie, UMR 1064, ITUN, Nantes, France
| | - Sophie Loubersac
- CHU Nantes, Nantes Université, Service de biologie et médecine de la reproduction, Nantes, France; Nantes Université, Inserm, Centre de Recherche en Transplantation et Immunologie, UMR 1064, ITUN, Nantes, France
| | - Paul Barrière
- CHU Nantes, Nantes Université, Service de biologie et médecine de la reproduction, Nantes, France; Nantes Université, Inserm, Centre de Recherche en Transplantation et Immunologie, UMR 1064, ITUN, Nantes, France
| | - Thomas Fréour
- CHU Nantes, Nantes Université, Service de biologie et médecine de la reproduction, Nantes, France; Nantes Université, Inserm, Centre de Recherche en Transplantation et Immunologie, UMR 1064, ITUN, Nantes, France.
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Agarwal A, Henkel R, Huang C, Lee M. Automation of human semen analysis using a novel artificial intelligence optical microscopic technology. Andrologia 2019; 51:e13440. [DOI: 10.1111/and.13440] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2019] [Revised: 08/09/2019] [Accepted: 08/30/2019] [Indexed: 12/30/2022] Open
Affiliation(s)
- Ashok Agarwal
- American Center for Reproductive Medicine Cleveland Clinic Cleveland OH USA
| | - Ralf Henkel
- American Center for Reproductive Medicine Cleveland Clinic Cleveland OH USA
- Department of Medical Bioscience University of the Western Cape Bellville South Africa
| | | | - Maw‐Sheng Lee
- Lee Women's Hospital Taichung Taiwan
- Institute of Medicine Chung Shan Medical University Taichung Taiwan
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Efrat M, Stein A, Pinkas H, Unger R, Birk R. Dietary patterns are positively associated with semen quality. Fertil Steril 2018; 109:809-816. [PMID: 29778381 DOI: 10.1016/j.fertnstert.2018.01.010] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2017] [Revised: 12/28/2017] [Accepted: 01/09/2018] [Indexed: 02/07/2023]
Abstract
OBJECTIVE To study association of semen quality with a priori whole dietary pattern indexes, which reflect real-world dietary practices and the numerous combinations by which foods are consumed: Healthy Eating Index (HEI), Dietary Approaches to Stop Hypertension (DASH), alternate Mediterranean Diet score (aMED), and Alternative Healthy Eating Index (AHEI). DESIGN A cross-sectional single-center study. SETTING Hospital fertility center and university. PATIENT(S) A total of 280 men attending fertility center from 2012 to 2015. INTERVENTION(S) Food frequency questionnaire (FFQ) and semen and sperm analysis. MAIN OUTCOME MEASURE(S) Food consumption with the use of FFQ and HEI, AHEI, aMED, DASH nutritional individual scoring indexes. Semen parameters, including semen volume, sperm concentration, motility, total count, and morphology. RESULT(S) Comparing the highest and lowest quartiles of the nutritional indexes, men in the highest quartiles of HEI, AHEI, aMed, and DASH indexes had significantly higher adjusted means of sperm concentration (by 10%, 45%, and 24% for HEI, AHEI, and DASH, respectively), normal sperm morphology (by 21% and 8% for AHEI and DASH, respectively), total sperm count (by 29% for AHEI), and sperm motility (by 6% and 11% for aMed and HEI, respectively). CONCLUSION(S) Adherence to any of the four dietary indexes is associated with better overall sperm quality, with AHEI best associated. Following our novel findings, we recommend using AHEI as a clinical and practical tool for public whole nutritional recommendation for semen quality.
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Affiliation(s)
- Michal Efrat
- Department of Nutrition, Faculty of Health Sciences, Ariel University, Ariel, West Bank, Israel; Mina and Everard Goodman Faculty of Life Sciences, Bar Ilan University, Ramat Gan, Israel
| | - Anat Stein
- Department of Obstetrics and Gynecology, Beilinson Medical Center, Infertility and In Vitro Fertilization Unit, Petah Tikva, Israel; Beilinson Medical Center, Petah Tikva, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Haim Pinkas
- Department of Obstetrics and Gynecology, Beilinson Medical Center, Infertility and In Vitro Fertilization Unit, Petah Tikva, Israel; Beilinson Medical Center, Petah Tikva, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Ron Unger
- Mina and Everard Goodman Faculty of Life Sciences, Bar Ilan University, Ramat Gan, Israel
| | - Ruth Birk
- Department of Nutrition, Faculty of Health Sciences, Ariel University, Ariel, West Bank, Israel.
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Efrat M, Stein A, Pinkas H, Breitbart H, Unger R, Birk R. Paraoxonase 1 (PON1) attenuates sperm hyperactivity and spontaneous acrosome reaction. Andrology 2018; 7:24-30. [DOI: 10.1111/andr.12552] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2018] [Revised: 07/26/2018] [Accepted: 08/18/2018] [Indexed: 12/19/2022]
Affiliation(s)
- M. Efrat
- Department of Nutrition Faculty of Health Sciences Ariel University ArielIsrael
- The Mina and Everard Goodman Faculty of Life Sciences Bar Ilan University Ramat‐GanIsrael
| | - A. Stein
- Department of Obstetrics and Gynecology Infertility and In Vitro Fertilization Unit Belinson Medical Center Petah Tiqva Israel
- Sackler Faculty of Medicine Tel Aviv University Tel Aviv‐Yafo Israel
| | - H. Pinkas
- Department of Obstetrics and Gynecology Infertility and In Vitro Fertilization Unit Belinson Medical Center Petah Tiqva Israel
- Sackler Faculty of Medicine Tel Aviv University Tel Aviv‐Yafo Israel
| | - H. Breitbart
- The Mina and Everard Goodman Faculty of Life Sciences Bar Ilan University Ramat‐GanIsrael
| | - R. Unger
- The Mina and Everard Goodman Faculty of Life Sciences Bar Ilan University Ramat‐GanIsrael
| | - R. Birk
- Department of Nutrition Faculty of Health Sciences Ariel University ArielIsrael
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Egeberg Palme DL, Johannsen TH, Petersen JH, Skakkebæk NE, Juul A, Jørgensen N, Almstrup K. Validation of image cytometry for sperm concentration measurement: Comparison with manual counting of 4010 human semen samples. Clin Chim Acta 2017; 468:114-119. [DOI: 10.1016/j.cca.2017.02.014] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2016] [Revised: 01/20/2017] [Accepted: 02/20/2017] [Indexed: 11/28/2022]
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Weber K, Waletzky A, Fendl D, Ordóñez P, Takawale P, Hein F, Riedel W, König A, Kunze M, Leoni AL, Rivera J, Quirici R, Romano I, Paepke S, Okazaki Y, Hardisty JF. New method for sperm evaluation by 3-dimensional laser scanning microscopy in different laboratory animal species. Int J Toxicol 2014; 33:353-61. [PMID: 25116922 DOI: 10.1177/1091581814545243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Sperm analysis is one of the end points in reproductive toxicology studies. Different methods for quantitative sperm analysis have been described. For qualitative morphological sperm analysis, either such techniques or smears of sperm and histological sperm staging are in use. Any of these methods provides morphological results on a light microscopy level. Laser scanning microscopy is a technique using a focused laser for scanning an object. The Olympus 3D Laser Scanning Microscope LEXT OLS4000 with optional possibilities of differential interference contrast provides a microscopic method for visualizing microasperities, which are far beyond the resolving power of a typical light or laser microscope. This technique was applied to sperm of mice, rats, rabbits, and cynomolgus monkeys at magnifications up to ×17 090. The obtained images are comparable to those of a scanning electron microscope under relatively low-power magnifications. Measurements on sperm parameters were taken by an integrated image analysis software tool. Abnormalities were easily detectable.
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Affiliation(s)
- Klaus Weber
- AnaPath GmbH, Buchsweg, Oberbuchsiten, Switzerland
| | | | - Diana Fendl
- BSL BIOSERVICE Scientific Laboratories GmbH, Behringstraße, Planegg, Germany
| | - Patricia Ordóñez
- Vivotecnia Research S.L., C/ Santiago Grisolia, Recinto PTM, Tres Cantos (Madrid), Spain
| | - Pradeep Takawale
- BSL BIOSERVICE Scientific Laboratories GmbH, Behringstraße, Planegg, Germany
| | - Felix Hein
- BSL BIOSERVICE Scientific Laboratories GmbH, Behringstraße, Planegg, Germany
| | - Wolfram Riedel
- BSL BIOSERVICE Scientific Laboratories GmbH, Behringstraße, Planegg, Germany
| | - Andres König
- Vivotecnia Research S.L., C/ Santiago Grisolia, Recinto PTM, Tres Cantos (Madrid), Spain
| | - Marc Kunze
- BSL BIOSERVICE Scientific Laboratories GmbH, Behringstraße, Planegg, Germany
| | - Anne-Laure Leoni
- BSL BIOSERVICE Scientific Laboratories GmbH, Behringstraße, Planegg, Germany
| | - Javier Rivera
- Vivotecnia Research S.L., C/ Santiago Grisolia, Recinto PTM, Tres Cantos (Madrid), Spain
| | - Roberto Quirici
- Olympus Schweiz AG, Chriesbaumstrasse, Volketswil, Switzerland
| | - Ivano Romano
- Olympus Schweiz AG, Chriesbaumstrasse, Volketswil, Switzerland
| | - Susanne Paepke
- AnaPath Services GmbH, Hammerstrasse, Liestal, Switzerland
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Double-blind prospective study comparing two automated sperm analyzers versus manual semen assessment. J Assist Reprod Genet 2013; 31:35-43. [PMID: 24242989 DOI: 10.1007/s10815-013-0139-2] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2013] [Accepted: 11/01/2013] [Indexed: 10/26/2022] Open
Abstract
PURPOSE Despite controversy regarding its clinical value, male fertility investigation mainly relies on semen analysis. Even though reference guidelines are available, manual sperm analysis still suffers from analytical variability, thus questioning the interest of automated sperm analysis systems. The aim of this study is to compared automated computerized semen analysis systems (SQA-V GOLD and CASA CEROS) to the conventional manual method in terms of accuracy and precision. METHODS We included 250 men in this double-blind prospective study. The SQA-V GOLD (Medical Electronic Systems) and CEROS, CASA system (Hamilton Thorne) were compared to the standard manual assessment based on the WHO 5th Edition. The main outcome measures were sperm concentration, total sperm number, total motility, progressive motility, non-progressive motility, morphology, motile sperm concentration (MSC) and progressively motile sperm concentration (PMSC) with the three methods. RESULTS Statistical analysis of the test results from the automated systems and the manual method demonstrated no significant differences for most of the semen parameters. The Spearman coefficients of rank correlation (rho) for CASA and the SQA-V GOLD automated systems vs. the manual method were: Sperm concentration (0.95 and 0.95), total sperm number (0.95 and 0.95), MSC (0.94 and 0.96) and PMSC (0.94 and 0.93) correspondingly. Concerning sperm morphology, both automated systems demonstrated high specificity (Sp) and negative predictive values (NPV), despite significantly different medians (CASA: 83.7 % for Sp and 95.2 % for NPV, SQA-V: 97.9 % for Sp and 92.5 %). The highest precision (lowest 95 % confidence interval for duplicate tests) for all semen variables was found in the SQA-V GOLD. CONCLUSIONS The advantages of using automated semen analysers are: Standardization, speed (lower turnaround time), precision, reduced potential for human error, automated data recording and less need for highly skilled professionals to run the systems. The disadvantages of using automated systems are: notably the problem with testing some atypical samples and the inability to perform an assessment of morphology abnormalities. Based on the results of this study, the SQA-V Gold demonstrated better agreement vs. the manual method. In conclusion, automated semen analyzers can be used for routine semen analysis providing rapid clinically acceptable results with higher precision, and positively impacting laboratory standardization.
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Egeberg DL, Kjaerulff S, Hansen C, Petersen JH, Glensbjerg M, Skakkebaek NE, Jørgensen N, Almstrup K. Image cytometer method for automated assessment of human spermatozoa concentration. Andrology 2013; 1:615-23. [DOI: 10.1111/j.2047-2927.2013.00082.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2012] [Revised: 01/22/2013] [Accepted: 02/22/2013] [Indexed: 11/29/2022]
Affiliation(s)
- D. L. Egeberg
- University Department of Growth and Reproduction; Rigshospitalet; Copenhagen; Denmark
| | | | - C. Hansen
- Pig Research Centre; Danish Agriculture and Food Council; Copenhagen; Denmark
| | - J. H. Petersen
- Institute of Public Health; Department of Biostatistics; University of Copenhagen; Copenhagen; Denmark
| | | | - N. E. Skakkebaek
- University Department of Growth and Reproduction; Rigshospitalet; Copenhagen; Denmark
| | - N. Jørgensen
- University Department of Growth and Reproduction; Rigshospitalet; Copenhagen; Denmark
| | - K. Almstrup
- University Department of Growth and Reproduction; Rigshospitalet; Copenhagen; Denmark
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11
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Lu JC, Huang YF, Lü NQ. Computer-aided sperm analysis: past, present and future. Andrologia 2013; 46:329-38. [PMID: 23550608 DOI: 10.1111/and.12093] [Citation(s) in RCA: 70] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/29/2013] [Indexed: 11/30/2022] Open
Affiliation(s)
- J. C. Lu
- Department of Laboratory Science; Nanjing Hospital; Jiangsu Corps; The Armed Police Force; PLA; Nanjing China
| | - Y. F. Huang
- Institute of Clinical Laboratory Medicine; Jinling Hospital; Nanjing China
| | - N. Q. Lü
- Jiangsu Family Planning Research Institute; Nanjing China
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Agarwal A, Sharma RK. Automation is the key to standardized semen analysis using the automated SQA-V sperm quality analyzer. Fertil Steril 2007; 87:156-62. [PMID: 17081526 DOI: 10.1016/j.fertnstert.2006.05.083] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2006] [Revised: 05/31/2006] [Accepted: 05/31/2006] [Indexed: 11/21/2022]
Abstract
OBJECTIVE To evaluate the performance of the automated semen quality analyzer system for assessing sperm quality. DESIGN Double-blind prospective study. SETTING Tertiary care hospital. PATIENT(S) Fifty healthy men donated semen samples. INTERVENTION(S) None. MAIN OUTCOME MEASURE(S) Precision, accuracy and agreement between automated and manual semen analysis methods was assessed for sperm concentration, motility, morphology, and known concentrations of latex bead quality control media. RESULT(S) A good agreement was seen between the results of sperm concentration reported by the SQA-V automated analyzer (Spermalite/SQA-V; Medical Electronic Systems Ltd, Caesarea Industrial Park, Israel) and those obtained manually. A similar linearity was seen when the SQA-V results were compared with the manual data and also when the manual results of individual operators were compared with each other. The automated assessment of morphology showed high sensitivity (89.9%) for identifying percent normal morphology, and the precision of the SQA-V was considerably higher when compared with the manual method. The interoperator variability for manual assessment was significant. The automated analysis was quick compared with the manual method. CONCLUSION(S) The SQA-V can be used interchangeably with manual semen analysis methods for examining sperm concentration and motility. The automated SQA-V analyzer is more precise and shows the ability to accurately classify normal versus abnormal sperm morphology.
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Affiliation(s)
- Ashok Agarwal
- Reproductive Research Center, Glickman Urological Institute, Cleveland, Ohio 44195, USA.
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