Revision as of 17:30, 11 January 2013

<a href="/index.php?title=RiliB%C3%84K%20zu%20Ejakulatuntersuchungen">Click here</a> to read the German version of "RiliBÄK".

Quality assessment settings

Before using Quality assessment, check the basic parameters in the <a href="/index.php?title=MedITEX_IVF_Settings#Semen_analysis">settings</a> of MedITEX IVF.

• You can access the settings from the menu System -> Configuration / administration -> Settings on the top of the window.
• Go to System -> Functions -> Semen analysis and check "Activate / deactivate Quality assessment".

As number of differentiating cells for motility and morphology by default 200 sperm are set. This number is the minimum value that is to be counted according to the directive per sperm count.

Also the specification of the workplace, the examination and the method should be entered here. The data will be automatically transferred to your Quality assessment entry screen.

The dilution or enrichment of the ejaculate and / or the number of the counting fields must be selected in accordance with an orienting preliminary examination. If the sperm concentration is less than 1-2 sperm per high power field (objective magnification 40-fold), the sample should be enriched. Finds then less than 200 sperm per counting grid of the counting chamber, eliminates the requirement of at least 2 x 200 to be counted spermatozoa.

These settings will be loaded on every Quality assessment calculation as default values ​​and can be edited in addition, depending on the special case.

Using Quality assessment

The Quality assessment functionality is used when conducting a Semen analysis. From a male patient window, select Lab. diagnosis. From the new window, click on New sample and choose Semen analysis.

Examinations can be conducted either manually or automatically (CASA = Sperm class analyzer).

The examination of sperms in a counting chamber is separated according to

1. Concentration (number),
2. Morphology (normal or abnormal percentage)
3. Motility (movement in 3 stages: progressive movement, locally movable immotile percentage)

These are performed in duplicate determinations then evaluated and documented.

If you check the box Use quality assessment, the Concentration, Motility and Morphology fields will not be able to be entered on this window. This method requires a new way for the calculation.

Switch to the Quality assessment tab to input the data.

The examinations are independent and may change according to the parameters. They can also be evaluated separately.

Examining the concentration

Switch to the tab Quality assessment -> Sperm counts.

In order to calculate the concentration, folow these steps:

1. Fill the counting chamber with the sample;
2. The two halves of counting chambers are examined separately. Each one accounts for a separate analysis: number 1 and number 2.

Exemaning the motility and morphology

When using quality assessment, at least 400 sperms need to be counted. 200 from the first chamber and another 200 for the second. If the number of sperms are less than 200, the counting may proceed with a smaller quantity.

Motility

The examination carried on the sperm, identifies its motility: progressive motile, locally motile and immotile .

Note: for Germany, the values ​​of WHO A and WHO B must be calculated separately according to the DIR regulations!

In order to make this process faster, MedITEX IVF offers the WHO sperm calculator and the Motility counter.

To learn more about the Motility counter , <a href="/index.php?title=Motility_counter">click here</a>.

Morphology

The examination of sperm morphology needs to be carried out for both analysis.

Documentation

Result

The evaluation of results have to be made immediately after the completion of the examination.

Please open the second tab Result .

Result of the sperm concentration

Result of the sperm motility

Result of the motility

Semen analysis quality assessment

Every month, after achieving an amount of 50 semen analysis or more, you must generate a long-term validation.

Click on Reports -> Semen analysis quality assessment

Long-term validation preparation

All results of the internal quality assurance are documented separately by parameter and workplace.

First step: select a parameter and a workplace Parameters: Concentration; Motility WHO AB; Motility WHO C; Motility WHO D; Morphology.

All results of internal quality assessment have to be documented separately by parameter and workplace.

Second step: evaluation of all duplicate determinations per parameter per workplace

All results of internal quality assessment have to be documented separately by parameter and workplace.

Third Step: flowing assessment/ current assessment      n = number of pairs of values ​​(immediately reviews)      d = difference of the value pairs      MWd = mean deviation = 1: n * Sum (d)      Sd = standard deviation of the difference = sqrt (1: (n-1) * Sum ([d MWd] 2)) Assessment: MWd ≤ 1.96 * sd: sqrt (n)

Fourth Step: control period / 50 value pairs After reaching the 50 value pair or the control period, an information window remind you of the long-term assessment.

All results of internal quality assessment have to be documented separately by parameter and workplace.

Fifth Step: Long-term validation (for the period evaluated single results) The long-term validation is to be performed individually for each parameter!

Is the mean value of the difference greater than the formula value, may no results be issued, until the cause is cleared and removed. The process must be documented. The fields cause, corrective action, eliminated and person (correction) need to be completed. Is this not the case, "information messages" remember on it.

In the upper half of the window you see per line the results of the long-term validation of one parameter or a workplace. Below there is a list of the single duplicate determinations. The associated semen analysis can be viewed by "double-click" or "right-click".