Lack of standardization in performance of the semen analysis among laboratories in the United States.

To determine the level of standardization in performance of the semen analysis among clinical laboratories in the United States. A survey was mailed to laboratories requesting information about the laboratory and performance of the semen analysis. Responses were received from 536 laboratories. Clinical laboratories enrolled in the American Association of Bioanalysts Andrology Proficiency Testing Program. None. None. Agreement among laboratories. Sixty-one percent of respondent laboratories were part of an assisted reproductive technology program. The laboratories perform less than 50 (53%), less than 10 (25%), or less than 5 (16%) andrology laboratory procedures per month. The laboratories routinely report sperm count (94% of laboratories), motility (95%), morphology (85%) and forward progression (69%), and semen volume (96%) as part of the semen analysis. Only 64% of laboratories routinely report abstinence, and 60% of laboratories indicate the criteria used for sperm morphology on the report form. The most common lower limits of normality for sperm count and motility were >20 x 10(6)/mL (77% of laboratories) and >50% (59% of laboratories), respectively. Few laboratories performed quality control for sperm counts (29%), motility (41%), and morphology (41%). These data indicate a significant lack of standardization in the performance and reporting of semen analyses among laboratories in the United States.