Schemes & Sample Information

In order for labs to accurately monitor and assess their performance through the use of samples provided by an external source, such as an EQA scheme, the nature and quality of these samples must be as close to ‘real’ specimens as possible. Our aim at EQASRM is to provide realistic samples that are good quality, biologically safe and interesting to laboratory staff performing the assay.

We offer 8 schemes relevant to the field of reproductive medicine. Laboratories enrol in the schemes relevant to their unit. 4 samples for each scheme are sent quarterly, per financial year. Laboratories are then asked to submit their results within a set time frame. Results can be submitted online, by fax or post. Statistical and graphical analysis of all results are then made available for online viewing and download. Laboratories can see how their quantitative results and qualitative assessments compare to those of other labs in this field.

Biological Samples

Sperm Concentration/Morphology

EQASRM creates three semen pools from carefully screened specimens, from which samples for testing are dispensed. We aim to provide samples with varying concentrations, all similar to those commonly assessed in the laboratory. The pools are fixed with a semen dilution fluid containing formaldehyde. The fourth sample sent for evaluation of concentration is a suspension of latex beads in serum.
The latex beads are of a similar diameter to that of a sperm head and are at a set concentration. By sending samples of this nature the laboratory is able to assess them as it would any sample it receives. Therefore, all variables such as mixing, pipetting, dilution, chamber differences and so on are tested.
These same semen samples are also used for morphological assessment by the lab. Laboratories create their own smears, stain and assess them according to their usual protocol. One pre-stained semen slide is also sent in an attempt to remove the ‘staining’ variable and compare labs merely on their criteria used for morphology assessment.

Antisperm Antibody Testing

Samples of screened serum are sent to labs for detection of antisperm antibodies. The samples may be from a serum pool or from individual donors. Labs are asked to use their usual method of testing for antisperm antibodies and report on whether the level of antibodies detected was clinically significant. A positive and negative control are always sent in each distribution.

Oestradiol Biochemistry

Sera from patients on gonadotrophin stimulated cycles is used for these samples. Samples are screened and pooled into 4 lots of specific concentration ranges. The ranges are reflective of those commonly seen in patients on stimulated cycles. Laboratories test these samples as per their biochemistry protocol.

Cytotoxicity Testing

Cytotoxicity testing is a crucial part of the IVF laboratory. EQASRM sends out a variety of samples in order for laboratories to test the sensitivity and validity of the assay they employ. The following are examples of samples that may be sent for testing:

• Embryo culture medium spiked with various toxins eg formaldehyde, chlorhexidine handwash, perfume etc.
• Embryo culture medium spiked with various products used in the IVF lab eg. propanediol, glycerol, lubricant, aqueous creams, handcleansers, etc.
• Products commonly used in the IVF lab: Cryopreservation straws, ET and IUI catheters, Semen Collection Devices, Condoms, mineral oil, etc.

Digital Samples

Sperm Motility

It would not be possible to send ‘live’ semen samples to labs given factors such as delays in transportation and temperature maintenance. Therefore, EQASRM sends out footage of semen samples recorded during microscopic evaluation. Recordings of four samples are done at 37C°, using an inverted or phase contrast microscope. Five fields of view per sample are recorded, each lasting approximately 20-25 seconds. Labs are asked to report the motility of each sample using the WHO 4 category system. This is so results can be standardized and appropriately compared with others.

Embryo & Blastocyst Grading

Footage of four Day2/3 and two blastocyst stage human embryos are recorded. The embryos are recorded whilst in culture medium microdroplets under oil at 37C°. The embryos are rotated and rolled using micropipettes as would be done in a routine assessment of embryo quality. Labs are asked to grade the embryo and, if appropriate, count the number of viable cells present. Other questions relating to each individual embryo are also asked in order to gain some insight into how labs assess their embryos and what their fate would be.

Sperm and Embryo footage is available on VHS Video, Windows or Mac compatible VCD or DVD. Please note that the Windows VCD will only run on Windows Media Player Version 8 or above.