湖南省未开展辅助生殖技术医院精液检验现状与改进策略

Current situation and improvement strategies of semen testing in hospitals without developing assisted reproductive technology in Hunan province

目的调查分析湖南省部分未开展辅助生殖技术医院精液检验现状,提出改进策略,以提高这些医院男性不育症诊断水平,促进生殖健康服务。方法通过问卷调查和现场考察,对湖南省67家未开展辅助生殖技术医院的精液检验现状进行调查,总结存在的问题并分析改进策略。结果67家医院中,59.7%(40/67)开展精液检验。其中45%(18/40)由专人负责,60%(24/40)检验人员经过培训,22.5%(9/40)持有证书。仅30%(12/40)开展精子形态学检验,20%(8/40)能按WHO标准染色判读。37.5%(15/40)使用计算机辅助精子分(CASA)系统,22.5%(9/40)配备相差显微镜。30%(12/40)有独立检查区域,32.5%(13/40)有独立取精室。17.5%(7/40)使用一次性载玻片观察精子浓度。57.5%(23/40)2022年平均日标本量<1例。67.5%(27/40)有标准操作规程,40%(16/40)以WHO《人类精液检查与处理实验室手册》第5版手册为依据。15%(6/40)有室内质控,12.5%(5/40)参加室间质评。55%(22/40)希望参加室间质评。结论目前未开展辅助生殖技术医院精液检验水平薄弱,亟需多方位改进,包括:重视开展,建立生殖医联体上下联动帮扶,设立省级质控中心开展室间质评,成立专业委员会提供交流平台,举办培训班提升人员水平,将孕前精液检查纳入公共卫生项目等。

Objective To investigate the current status of semen testing in the hospitals without assisted reproductive technology in Hu-nan Province,propose improvement strategies to enhance the diagnosis of male infertility and promote reproductive health services in these hospitals.Methods Questionnaire surveys and on-site investigations were conducted to examine the semen testing status in 67 hospitals without assisted reproductive technology in Hunan Province.The existing problems were summarized,and improvement strate-gies were suggested.Results Among the 67 hospitals,59.7%(40/67)performed semen testing.Of these,45%(18/40)possessed dedicated personnel,60%(24/40)possessed staff received relevant training,and 22.5%(9/40)held certificates:.0nly 30%(12/40)conducted sperm morphology testing,among them 20%(8/40)able to stain and interpret following WHO0 standards.The hospitals of 37.5%(15/40)used computer-assisted spermanalysis(CASA)systems,and 22.5%(9/40)wereequipped withphase-contrast microscopes.30%(12/40)had dedicated examination areas,and 32.5%(13/40)had independent ejaculation rooms,17.5%(7/40)used disposable slides to observe sperm concentration.In 2022,the hospitals of 57.5%(23/40)had an average daily sample volume<1.The hospital of 67.5%(27/40)performed standard operating procedures,40%(16/40)followed the WH05th la-boratory manual for routine testing,15%(6/40)conducted internal quality control,and 12.5%(5/40)participated in external quality assessment(EQA).Another 55%(22/40)wished to participate in EQA.Conclusion The semen testing capacity in the hospitals,in which assisted reproductive technology is not yet carried out currently,urgently requiring multifaceted improvements.The proposed strategies include emphasizing semen testing,establishing reproductive medicine consortia for comprehensive support,establishing a provincial quality control center for EQA,founding a professional commitee for a learning platform,offering training to enhance staff expertise,and including the pre-pregnancy semen testing in public health programs.