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Chapter 21 - The Future of Computer-Assisted Semen Analysis in the Evaluation of Male Infertility

from Section 4 - Laboratory Evaluation and Treatment of Male Infertility

Published online by Cambridge University Press:  06 December 2023

By
David Mortimer  and
Sharon T. Mortimer
Edited by
Douglas T. Carrell ,
Alexander W. Pastuszak  and
James M. Hotaling
Douglas T. Carrell
Affiliation:
Utah Center for Reproductive Medicine
Alexander W. Pastuszak
Affiliation:
University of Utah
James M. Hotaling
Affiliation:
Utah Center for Reproductive Medicine
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Summary

This chapter reviews the current limitations of CASA in routine clinical andrology and describes a path by which it could become a robust analytical technology that can be employed in accredited expert clinical andrology laboratories. Particular focus is on the need for premarketing validation by manufacturers for CASA-based semen analysis applications, as well as the impact that software differences have on the absolute values reported for sperm kinematics. Without close comparability between CASA systems it will continue to be extremely difficult to establish either decision limits or reference ranges that can be applied clinically for either diagnostic or prognostic purposes.

Keywords

sperm motilitykinematicscomputer-aided sperm analysisCASAsperm function testssperm morphologysperm vitality
Type
Chapter
Information
Men's Reproductive and Sexual Health Throughout the Lifespan
An Integrated Approach to Fertility, Sexual Function, and Vitality
 , pp. 165 - 174
Publisher: Cambridge University Press
Print publication year: 2023

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References

Mortimer, ST. A critical review of the physiological importance and analysis of sperm movement in mammals. Hum Reprod Update. 1997;3:403–439.Google Scholar
Björndahl, L, Mortimer, D, Barratt, CLR, et al. A Practical Guide to Basic Laboratory Andrology. Cambridge University Press; 2010.Google Scholar
MacLeod, J, Gold, RZ. The male factor in fertility and infertility. III. An analysis of motile activity in the spermatozoa of 1000 fertile men and 1000 men in infertile marriage. Fertil Steril. 1951;2:187–204.Google Scholar
Mortimer, D. Objective analysis of sperm motility and kinematics. In: Keel, BA, Webster, BW, eds. Handbook of the Laboratory Diagnosis and Treatment of Infertility. CRC Press; 1990:97–133.Google Scholar
Mortimer, D. Practical Laboratory Andrology. Oxford University Press; 1994.CrossRefGoogle Scholar
David, G, Serres, C, Jouannet, P. Kinematics of human spermatozoa. Gamete Res. 1981;4:83–95.Google Scholar
Mortimer, D, Mortimer, ST. Value and reliability of CASA systems. In: Ombelet, W, Bosmans, E, Vandeput, H, Vereecken, A, Renier, M, Hoomans, EH, eds. Modern ART in the 2000’s: Andrology in the Nineties. Parthenon Publishing, 1998:73–89.Google Scholar
Mortimer, D, Aitken, RJ, Mortimer, ST, Pacey, AA. Clinical CASA: the quest for consensus. Reprod Fertil Dev. 1995;7:951–959.CrossRefGoogle ScholarPubMed
Mortimer, D, Mortimer, ST. Routine application of CASA in human clinical andrology and ART laboratories. In: Flanagan, J, Björndahl, L, Kvist, U, eds. Proceedings of the 13th International Symposium on Spermatology. Springer Nature Switzerland AG, 2018:183–197.Google Scholar
ESHRE Andrology Special Interest Group. Guidelines on the application of CASA technology in the analysis of spermatozoa. Hum Reprod. 1998;13:142–145.Google Scholar
Mortimer, ST van der Horst, G, Mortimer, D. The future of computer‐aided sperm analysis. Asian J Androl. 2015;17:545–553.Google Scholar
Sanders, D, Fensome-Rimmer, S, Woodward, B. Uncertainty of measurement in andrology: UK best practice guideline from the Association of Biomedical Andrologists. Br J Biomed Sci. 2017;74:157–162.Google Scholar
Yeste, M, Bonet, S, Rodríguez-Gil, JE, Rivera Del Álamo, MM. Evaluation of sperm motility with CASA-Mot: which factors may influence our measurements? Reprod Fertil Dev. 2018;30:789–798.CrossRefGoogle ScholarPubMed
Schubert, B, Badiou, M, Force, A. Computer-aided sperm analysis, the new key player in routine sperm assessment. Andrologia. 2019;51:e13417.Google Scholar
Douglas-Hamilton, DH, Smith, NG, Kuster, CE, Vermeiden, JP, Althouse, GC. Particle distribution in low-volume capillary-loaded chambers. J Androl. 2005;26:107–114.CrossRefGoogle ScholarPubMed
Douglas-Hamilton, DH, Smith, NG, Kuster, CE, Vermeiden, JP, Althouse, GC. Capillary-loaded particle fluid dynamics: effect on estimation of sperm concentration. J Androl. 2005;26:115–122.Google Scholar
Mortimer, D. Sperm transport in the female genital tract. In: Grudzinskas, JG, Yovich, JL, eds. Cambridge Reviews in Human Reproduction, Volume 2: Gametes – The Spermatozoon. Cambridge University Press; 1995:157–174.Google Scholar
Björndahl, L, Barratt, CLR, Mortimer, D, Jouannet, P. How to count sperm properly: checklist for acceptability of studies based on human semen analysis. Hum Reprod. 2016;31:227–232.Google ScholarPubMed
Dearing, C, Jayasena, C, Lindsay, K. Can the Sperm Class Analyser (SCA) CASA-Mot system for human sperm motility analysis reduce imprecision and operator subjectivity and improve semen analysis? Hum Fertil (Camb). 2021;24(3):208–218.Google Scholar
Tomlinson, MJ, Naeem, A. CASA in the medical laboratory: CASA in diagnostic andrology and assisted conception. Reprod Fertil Dev. 2018;30:850–859.Google Scholar
Lammers, J, Splingart, C, Barrière, P, Jean, M, Fréour, T. Double-blind prospective study comparing two automated sperm analyzers versus manual semen assessment. J Assist Reprod Genet. 2014;31:35–43.Google Scholar
Dearing, CG, Kilburn, S, Lindsay, KS. Validation of the sperm class analyser CASA system for sperm counting in a busy diagnostic semen analysis laboratory. Hum Fertil. 2014;17:37–44.Google Scholar
Agarwal, A, Henkel, R, Huang, C-C, Lee, M-S. Automation of human semen analysis using a novel artificial intelligence optical microscopic technology. Andrologia. 2019;51:e13440.Google Scholar
Cooper, TG, Noonan, E, von Eckardstein, S, et al. World Health Organization reference values for human semen characteristics. Hum Reprod Update. 2010;16:231–245.Google Scholar
World Health Organization. WHO Laboratory Manual for the Examination and Processing of Human Semen. 5th ed. World Health Organization; 2010.Google Scholar
Björndahl, L. What is normal semen quality? On the use and abuse of reference limits for the interpretation of semen analysis results. Hum Fertil. 2011;14:179–186.Google Scholar
Mortimer, ST. CASA – practical aspects. J Androl. 2000;21:515–524.Google Scholar
Barratt, CLR, Björndahl, L, Menkveld, R, Mortimer, D. The ESHRE Special Interest Group for Andrology Basic Semen Analysis Course: a continued focus on accuracy, quality, efficiency and clinical relevance. Hum Reprod. 2011;26:3207–3212.CrossRefGoogle ScholarPubMed
Mortimer, D, Mortimer, ST. Laboratory investigation of the infertile male. In: Brinsden, PR, ed. A Textbook of In-Vitro Fertilization and Assisted Reproduction. 3rd ed. Taylor & Francis Medical Books; 2005:61–91.CrossRefGoogle Scholar
Mortimer, D, Mortimer, ST. Computer-aided sperm analysis (CASA) of sperm motility and hyperactivation. In: Carrell, DT, Aston, KI, eds. Spermatogenesis and Spermiogenesis: Methods and Protocols. Methods in Molecular Biology 927. Springer (Humana Press); 2013:77–87.Google Scholar
ESHRE Special Interest Group of Embryology and Alpha Scientists in Reproductive Medicine. The Vienna Consensus: report of an expert meeting on the development of ART laboratory performance indicators. Reprod Biomed Online. 2017;35:494–510.Google Scholar
Mortimer, ST, Schoëvaërt, D, Swan, MA, Mortimer, D. Quantitative observations of flagellar motility of capacitating human spermatozoa. Hum Reprod. 1997;12:1006–1012.Google Scholar
Alasmari, W, Barratt, CLR, Publicover, SJ, et al. The clinical significance of calcium signaling pathways mediating human sperm hyperactivation. Hum Reprod. 2013;28:866–876.Google Scholar
Mortimer, D, Serres, C, Mortimer, ST, Jouannet, P. Influence of image sampling frequency on the perceived movement characteristics of progressively motile human spermatozoa. Gamete Res. 1988;20:313–327.Google Scholar
Mortimer, D. Structured management as a basis for cost-effective infertility care. In: Gagnon, C, ed. The Male Gamete: From Basic Knowledge to Clinical Applications. Cache River Press; 1999:363–370.Google Scholar
Rowe, PJ, Comhaire, FH, Hargreave, TB, Mahmoud, AMA. WHO Clinical Manual for the Standardized Investigation, Diagnosis and Management of the Infertile Male. Cambridge University Press; 2000.Google Scholar
Mortimer, D, Mortimer, ST. The case against intracytoplasmic sperm injection for all. In: Aitken, J, Mortimer, D, Kovacs, G, eds. Male and Sperm Factors That Maximize IVF Success. Cambridge University Press; 2020:130–140.Google Scholar
Mortimer, D, Menkveld, R. Sperm morphology assessment: historical perspectives and current opinions. J Androl. 2001;22:192–205.CrossRefGoogle ScholarPubMed
Mortimer, D. Sperm form and function: beauty is in the eye of the beholder. In: van der Horst, G, Franken, D, Bornman, R, de Jager, T, Dyer, S, eds. Proceedings of 9th International Symposium on Spermatology. Monduzzi Editore; 2002:257–262.Google Scholar
Auger, J, Jouannet, P, Eustache, F. Another look at human sperm morphology. Hum Reprod. 2016;31:10–23.Google Scholar
Gatimel, N, Moreau, J, Parinaud, J, Léandri, RD. Sperm morphology: assessment, pathophysiology, clinical relevance, and state of the art in 2017. Andrology. 2017;5:845–862.Google Scholar
Mortimer, D. The functional anatomy of the human spermatozoon: relating ultrastructure and function. Mol Hum Reprod. 2018;24:567–592.Google Scholar
Coetzee, K, Kruger, TF, Lombard, CJ. Repeatability and variance analysis on multiple computer-assisted (IVOS) sperm morphology readings. Andrologia. 1999;31:163–168.Google Scholar
Mortimer, D. A technical note on the assessment of human sperm vitality using eosin-nigrosin staining. Reprod Biomed Online. 2020;40:851–855.Google Scholar
Mortimer, D, Curtis, EF, Camenzind, AR, Tanaka, S. The spontaneous acrosome reaction of human spermatozoa incubated in vitro. Hum Reprod. 1989;4:57–62.Google Scholar
Sadeghi, S, García-Molina, A, Celma, F, Valverde, A, Fereidounfar, S, Soler, C. Morphometric comparison by the ISAS® CASA-DNAf system of two techniques for the evaluation of DNA fragmentation in human spermatozoa. Asian J Androl. 2016;18:835–839.Google ScholarPubMed
ESHRE Andrology Special Interest Group. Consensus workshop on advanced diagnostic andrology techniques. Hum Reprod. 1996;11:1463–1479.Google Scholar
Mortimer, D, Curtis, EF, Miller, RG. Specific labelling by peanut agglutinin of the outer acrosomal membrane of the human spermatozoon. J Reprod Fertil. 1987;81:127–135.Google Scholar
Mortimer, D, Goel, N, Shu, MA. Evaluation of the CellSoft automated semen analysis system in a routine laboratory setting. Fertil Steril. 1988;50:960–968.Google Scholar
Bland, JM, Altman, DG. Statistical methods for assessing agreement between two methods of clinical measurement. Lancet. 1986;1:307–310.Google Scholar
International Standards Organization. ISO 15189:2012 Medical laboratories – Requirements for quality and competence. International Standards Organization; 2012.Google Scholar
International Standards Organization. ISO/TS 20914:2019 Medical laboratories – Practical guidance for the estimation of measurement uncertainty. International Standards Organization; 2019.Google Scholar
International Standards Organization. ISO 23162:2021 Basic semen examination – Specification and test methods. International Standards Organization; 2021.Google Scholar

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