{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T09:26:47Z","timestamp":1790760407190,"version":"4.1.0"},"reference-count":20,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"5","license":[{"start":{"date-parts":[[2026,3,3]],"date-time":"2026-03-03T00:00:00Z","timestamp":1772496000000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:p>\n                    This study evaluated technicians\u2019 ability to identify sperm morphology via external quality assessment (EQA) and identified challenging defect types causing significant interparticipant discrepancies. A longitudinal study was conducted from 2019 to 2024 to assess the ability of technicians at various laboratories to identify sperm morphology using standardized EQA protocols and distributed sperm images. Morphological classification was performed using the criteria of the World Health Organization, 6\n                    <jats:sup>th<\/jats:sup>\n                    edition. Correct identification rates, participant pass rates, and defect-specific accuracy rates were statistically analyzed. The overall correct identification rate (mean \u00b1 standard deviation [s.d.]) was 81.3% \u00b1 27.0%, while the correct identification rate of normal sperm morphology (mean \u00b1 s.d.) was only 51.1% \u00b1 25.5%. Although the overall correct identification rate of abnormal sperm morphology (mean \u00b1 s.d.) was as high as 96.1% \u00b1 8.9%, the overall correct identification rate across all defect categories (mean \u00b1 s.d.) was only 60.2% \u00b1 21.7%. The identification of sperm head defects was the most challenging, with a correct identification rate (mean \u00b1 s.d.) of only 57.0% \u00b1 20.7%, while the correct identification rate of sperm tail defects (mean \u00b1 s.d.) was the highest at 70.5% \u00b1 23.5%. Among sperm head defects, the correct identification rate of head size defects (mean \u00b1 s.d.) was the lowest at 53.4% \u00b1 22.0%. Laboratories that participated for 5 consecutive years showed significant improvements in total and normal morphology scores. Image-based EQA effectively assesses the technicians\u2019 competency and serves as an educational tool. Normal sperm morphology evaluation should avoid overly strict criteria, while abnormal sperm morphology assessment requires enhanced focus on specific defect types.\n                  <\/jats:p>","DOI":"10.4103\/aja202582","type":"journal-article","created":{"date-parts":[[2026,3,3]],"date-time":"2026-03-03T16:00:13Z","timestamp":1772553613000},"page":"542-547","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":1,"title":["Evaluation of technicians\u2019 ability to accurately identify sperm morphology through EQA programs in China: a 5-year nationwide study (2019\u20132024)"],"prefix":"10.4103","volume":"28","author":[{"given":"Yan","family":"Zheng","sequence":"first","affiliation":[{"name":"Department of Andrology\/Human Sperm Bank, West China Second University Hospital, Sichuan University, Chengdu 610000, China"},{"name":"Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu 610000, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ying-Bi","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Andrology\/Human Sperm Bank, West China Second University Hospital, Sichuan University, Chengdu 610000, China"},{"name":"Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu 610000, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lin","family":"Yu","sequence":"additional","affiliation":[{"name":"Department of Andrology\/Human Sperm Bank, West China Second University Hospital, Sichuan University, Chengdu 610000, China"},{"name":"Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu 610000, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuan","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Andrology\/Human Sperm Bank, West China Second University Hospital, Sichuan University, Chengdu 610000, China"},{"name":"Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu 610000, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jin-Tao","family":"Yuan","sequence":"additional","affiliation":[{"name":"Sichuan Sexology Association, Chengdu 610000, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cheng-Cheng","family":"Diao","sequence":"additional","affiliation":[{"name":"Sichuan Sexology Association, Chengdu 610000, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yi","family":"Ma","sequence":"additional","affiliation":[{"name":"Sichuan Sexology Association, Chengdu 610000, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ye-Lin","family":"Jia","sequence":"additional","affiliation":[{"name":"Department of Andrology\/Human Sperm Bank, West China Second University Hospital, Sichuan University, Chengdu 610000, China"},{"name":"Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu 610000, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fu-Ping","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Andrology\/Human Sperm Bank, West China Second University Hospital, Sichuan University, Chengdu 610000, China"},{"name":"Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu 610000, 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