精液分析标准化的重要性与紧迫性

Is the Semen Analysis a Reliable Test?

精液分析是一项十分重要的用于评估男性生殖能力的临床检验项目。然而,最近的报告提示精液分析的结 果并不可靠。男科学实验室的质控常常被认为是存在有问题的,在进行精液分析时许多实验室并不按常规进行质 量控制。质量保证工作在男科实验室常常被忽略。男科实验室室间检验能力验证计划还未被推广,最近几个项目 检测的结果表明,室间检验结果存在很大的变异。各实验室间执行着不同的标准使得一个实验室与另一个实验间 难以进行结果比对。通过执行以下几点建议可以获得可靠的精液分析结果:①所有实验室应该采用普遍接受的检 测标准和指标,②所有实验室应该参加室间测评计划,③实验室应该执行有效的室内质控和质量保证计划,以保证 报告结果准确和可重复,④临床医生应该指定患者在严格执行上述建议的实验室接受精液分析,或只认可这些实 验室提供的精液分析结果。

The semen analysis is one, if not the most, important and widely used clinical laboratory test to evaluate the fertility potential of the male. However, recent reports have suggested that the semen analysis is unreliable. Quality control in the andrology laboratory is often seen as problematic, and many laboratories do not routinely employ QC procedures in semen testing. Quality assurance is an often overlooked and unappreciated aspect of overall quality laboratory performance. External proficiency testing programs in andrology are not universally accepted, and the results from the few programs currently available demonstrate huge variations between laboratories. Numerous different standards and criteria are being used by andrology laboratories, making it difficult if not impossible to compare results from one laboratory to another. However, reliable semen analyses can be obtained by following several recommendations: ①all laboratories performing the semen analysis should adopt universally accepted performance standards and criteria, ② all laboratories performing this test should participate in external proficiency testing programs, ③andrology laboratories should implement effective internal quality control and quality assurance programs to ensure that the results reported are accurate and reproducible, and ④physicians should only refer their patients to, or accept semen analysis results from, laboratories that have stringently followed these recommendations.