External Quality Assurance Schemes for Reproductive Medicine

Frequently Asked Questions

What Does ALTM And RTAC Stand For?

These terms are used in our statistical analysis reports.

  1. ALTM: All laboratory trimmed means (ALTM) – the top 10% and bottom 10% data points are excluded in an attempt to remove outliers that can distort the calculation of the mean. This is a fairly standard way of calculating the mean for EQA schemes (Healy, 1979) but requires a large number of participants to be valid.
  2. RTAC: These represent the specialist laboratories that are accredited by RTAC (Reproductive Technology Accreditation Committee), the accrediting committee of the Fertility Society of Australia. The use of RTAC accreditation allows us to identify the specialist laboratories without having to make a judgement about their competence. The separation of these results will allow general pathology laboratories to compare themselves with specialist laboratories.

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How Is The Bias Calculated?

The bias is simply the difference between your result and the mean value, represented as a percentage. It should be noted, however, that the bias of specialist labs will be calculated from the RTAC mean, whilst the non-RTAC labs have the bias calculated from the overall ALTM. The formula is as follows:

Bias = ([x - ø]/ø) × 100

where: x = your result
ø = mean value (RTAC or ALTM)

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What Are The Lower Reference Limits (LRL) For Sperm Motility According To The WHO Manual, 5th Ed?

LRL Total Motility (PR + NP) = 40%
LRL Progressive Motility (PR) = 32%

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What Guidelines Should A Laboratory Use To Set Their Own "Control" And "Action" Limits?

The role of an external QAP service such as EQASRM is to provide an objective service by supplying a set group of samples and subsequently comparing results on a large scale. It is currently not our role to police or make decisions on the performance of your lab. How labs choose to interpret how they have performed in an EQA scheme should be decided by senior staff members and clearly set out in appropriate procedure manuals. We recommend labs refer to the WHO Manual for the Examination and Processing of Human Semen, 5th Edition, 2010, Cambridge University Press. Chapter 7, Quality Assurance and Quality Control, details methods of calculating control limits depending on variables specific to your lab.

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Explanation Of Methods And Assays

IBT : Immunobeat Test. This includes both direct(washed sperm) and indirect (seminal plasma & serum) immunobead tests for detection of antisperm antibodies. Immunobeads are polyacrulamide spheres bound with rabbit antihuman immunoglobulins. Both IgG and IgA antibodies are detected using this test. Some brands availabe are Irvine Scientific and Laboserv GmbH.

MAR : Mixed Antiglobulin Reaction. Fresh semen is mixed with latex particles coated with human IgG or IgA. Monospecific anti-human-IgG antiserum is then added and the formation of agglutinates between particles and sperm indicate the presence of antibodies. Some brands available are Fertility Technologies and Fertipro N.V.

MEA : Mouse Embryo Assay. Used for the detection of cytotoxic products in the IVF laboratory. MEA protocols can involve the culture to blastocyst stage of either 2pn stage or 2 cell mouse embryos.

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Can A Laboratory Enrol At Any Time During The Year?

Yes. A laboratory can enrol at any time and will only pay for the distributions remaining in that financial year. Please note that although the individual schemes will be charged on a pro-rata basis, the full registration fee will be incurred.

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How Should EQA Samples Be Stored?

Testing of EQA samples should be performed immediately upon their receipt. However, if this is not possible, all biological samples should be refrigerated to prevent sample detioration.

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How Is Sperm Motility Defined In The WHO Manual For The Examination And Processing Of Human Semen, 5th Edition, 2010?

Progressive Motility (PR): Spermatozoa moving actively, either linearly or in a large circle, regardless of speed.

Non-Progressive Motility (NP): All other patterns of motility with an absence of progression ie swimming in small circles, the flagellar force hardly displacing the head, or when only flagellar beat can be observed.

Immotility (IM): No movement.

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