Skip to the main content

Professional paper

Sperm morphology assessment according to WHO and strict criteria: method comparison and intra-laboratory variability

Andrea Čipak ; University Department of Obstetrics and Gynecology, Zagreb University Hospital Center, Zagreb, Croatia
Patrik Stanić ; University Department of Obstetrics and Gynecology, Zagreb University Hospital Center, Zagreb, Croatia
Koraljka Đurić ; Medical Biochemistry Laboratory, Sunce Polyclinic, Zagreb, Croatia
Tihana Serdar ; Department of Laboratory Medicine, Dubrava University Hospital, Zagreb, Croatia
Ernest Suchanek ; Fertility Clinic,Tawam Hospital, Johns Hopkins Medicine, Al Ain, Abu Dhabi, U.A.E.

Full text: croatian pdf 172 Kb

page 87-94

downloads: 446


Full text: english pdf 172 Kb

page 87-94

downloads: 469



Background: Assessment of sperm morphology is one of the most important steps in the evaluation of male partner in infertile couples. However, significant inter- and intra-laboratory variations can cause difficulties in interpretation, misdiagnoses, and consequently lead to confusion. Therefore, it is necessary to minimize these variations to eliminate consequential errors and ensure intra- and inter-laboratory reproducibility.
Materials and methods: Semen specimens were obtained from 49 consecutive male patients attending Andrology Laboratory for fertility evaluation. Two sperm morphology assessment criteria were compared: 1) semen smear prepared by Giemsa and assessed by World Health Organization (WHO) criteria; and 2) semen smear prepared by Spermac and assessed by strict criteria. Intra-laboratory comparison of morphological examination was also carried out.
Results: The diagnosis of teratozoospermia by both WHO and strict criteria was concordant in 45 of 49 cases. Intra-rater agreement between the observers was similar for WHO and strict criteria (kappa, 0.700 vs. 0.715).
Conclusions: Morphology assessment by WHO and strict criteria is concordant in diagnosing teratozoospermia and good inter-observer agreement can be achieved after proper training, mindful smear examination and complying with the classification systems.


spermatozoa, infertility, male, observer variation

Hrčak ID:



Article data in other languages: croatian

Visits: 1.904 *