A Structured Assessment for the Assessment of Human Sperm Morphology

Sperm morphology has historical value for predicting fertility outcomes, which has diminished in the last few decades. Ample data show that most labs using the Strict morphology scheme are overly critical with few normal sperm found even in fertile men. In many centers, morphology no longer correlates with success after assisted reproductive therapies. Many different interpretations of classification criteria exist as seen clearly in proficiency testing where intra-observer and interlaboratory variation typically exceeds acceptable and useful limits. The WHO reference ranges for normal Strict morphology encompass median and upper limits that many laboratories never attain.