title: Variability in the morphologic assessment of human sperm: use of the strict criteria recommended by the World Health Organization in 2010.
abstract: OBJECTIVE
  To determine the variability in the recognition of normal sperm and various sperm defects using the strict criteria recommended by the World Health Organization (5th edition, 2010).
  
  
  METHODS
  Sperm morphologic assessment by three experienced evaluators.
  
  
  METHODS
  Image processing laboratory and reproduction research institute.
  
  
  METHODS
  Semen donors from a sperm bank.
  
  
  METHODS
  The morphology of 5,296 sperm was evaluated using statistical analyses of variability.
  
  
  METHODS
  The proportion and coefficients of variation (CVs) of normal sperm, defects of specific parts, and the categories of defects were measured. The degree of agreement between any two of the three evaluators was calculated. The multiple anomalies index, teratozoospermia index, sperm deformity index, and the CVs were also measured.
  
  
  RESULTS
  The CVs of normal sperm, multiple anomalies index, teratozoospermia index, and sperm deformity index were 4.80%, 4.14%, 5.75%, and 6.81%, respectively. A broader range (4.80%-132.97%) of CVs was observed for the recognition of various defects. The coefficients of the degree of agreement concerning specific morphologic parts of sperm varied (0.387-0.607), with lower relative values for the head and mid-piece than for the tail and cytoplasm.
  
  
  CONCLUSIONS
  The sperm head is more difficult to evaluate than the other parts using the criteria recommended by the World Health Organization in 2010. The degree of agreement concerning specific parts and various defects varied in broad ranges. A stricter definition for each defect is needed.
authors: Key Laboratory of Image Processing and Intelligent Control of the Ministry of Education, Department of Biomedical Engineering, School of Life Science and Technology, Huazhong University of Science and Technology, Wuhan, Hubei, People's Republic of China.
authors: Yongxin
authors: Y
authors: Wang
authors: Key Laboratory of Image Processing and Intelligent Control of the Ministry of Education, Department of Biomedical Engineering, School of Life Science and Technology, Huazhong University of Science and Technology, Wuhan, Hubei, People's Republic of China.
authors: Jiali
authors: J
authors: Yang
authors: Key Laboratory of Image Processing and Intelligent Control of the Ministry of Education, Department of Biomedical Engineering, School of Life Science and Technology, Huazhong University of Science and Technology, Wuhan, Hubei, People's Republic of China.
authors: Yanping
authors: Y
authors: Jia
authors: Research Institute of Family Planning, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, People's Republic of China.
authors: Chengliang
authors: C
authors: Xiong
authors: Research Institute of Family Planning, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, People's Republic of China.
authors: Tianqing
authors: T
authors: Meng
authors: Research Institute of Family Planning, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, People's Republic of China.
authors: Huangtao
authors: H
authors: Guan
authors: Research Institute of Family Planning, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, People's Republic of China.
authors: Wei
authors: W
authors: Xia
authors: Key Laboratory of Image Processing and Intelligent Control of the Ministry of Education, Department of Biomedical Engineering, School of Life Science and Technology, Huazhong University of Science and Technology, Wuhan, Hubei, People's Republic of China; Wuhan National Laboratory for Optoelectronics, Huazhong University of Science and Technology, Wuhan, Hubei, People's Republic of China.
authors: Mingyue
authors: M
authors: Ding
authors: Key Laboratory of Image Processing and Intelligent Control of the Ministry of Education, Department of Biomedical Engineering, School of Life Science and Technology, Huazhong University of Science and Technology, Wuhan, Hubei, People's Republic of China. Electronic address: m.yuchi@hust.edu.cn.
authors: Ming
authors: M
authors: Yuchi
mesh_terms: D000328:Adult; D002478:Cells, Cultured; D002681:China / Q000453:epidemiology; D005260:Female; D006801:Humans; D007248:Infertility, Male / Q000453:epidemiology* / Q000473:pathology*; D008297:Male; D015588:Observer Variation; D017410:Practice Guidelines as Topic; D015995:Prevalence; D015203:Reproducibility of Results; D018570:Risk Assessment; D055101:Semen Analysis / Q000592:standards* / Q000706:statistics & numerical data*; D012680:Sensitivity and Specificity; D013094:Spermatozoa / Q000473:pathology*; D014019:Tissue Donors / Q000706:statistics & numerical data*; D055815:Young Adult
keywords: Sperm morphology assessment; agreement analysis; evaluation variability