Critical evaluation of two models of flow cytometers for the assessment of sperm DNA fragmentation: an appeal for performance verification.
Author(s)
Sharma, Rakesh
Gupta, Sajal
Henkel, Ralf
Agarwal, Ashok
Type
Journal Article
Abstract
Lack of standardized, reproducible protocols and reference values is among the challenges faced when using new or upgraded versions of instruments in reproductive laboratories and flow cytometry. Terminal deoxynucleotidyl transferase dUTP nick end labeling (TUNEL) assay combined with flow cytometry routinely used for diagnostic measurement of sperm DNA fragmentation (SDF) is a unique example. Any change in the setting of the standard instrument, including upgrades of hardware or software, can lead to different results and may affect clinicians' decision for treatment. Therefore, we compared TUNEL results of SDF obtained from a standard (C6) flow cytometer with a newer version of the same instrument (C6 Plus) and examined the cutoff, sensitivity, and specificity without calibration (adjustment) and after adjustment. Identical sperm preparation and matched acquisition settings were used to examine the performance of two flow cytometers. The strength of agreement of the results between the two observers was also assessed. After adjustment of the settings, overall concordance became high and the two cytometers showed 100% positive and negative predictive value with 100% area under the curve. The overall correlation coefficient observed between C6 and C6 Plus was highly significant (P < 0.0001; r = 0.992; 95% confidence interval [CI]: 0.982-0.997). After adjustment, the two cytometers showed very high precision of 98% and accuracy of >99%. The interobserver agreement on C6 flow cytometer for the two observers was 0.801 ± 0.062 and 0.746 ± 0.044 for C6 Plus. We demonstrated a strong agreement between the samples tested on the two flow cytometers after calibration and established the robustness of both instruments.
Date Issued
2019
Date Acceptance
2018-10-21
Citation
Asian Journal of Andrology, 2019, 21 (5), pp.438-444
ISSN
1008-682X
Publisher
Wolters Kluwer Medknow Publications
Start Page
438
End Page
444
Journal / Book Title
Asian Journal of Andrology
Volume
21
Issue
5
Copyright Statement
©The Author(s)(2019). This is an open access journal, and articles are distributed under the terms of the
Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which
allows others to remix, tweak, and build upon the work non-commercially, as long
as appropriate credit is given and the new creations are licensed under the identical
terms.
Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which
allows others to remix, tweak, and build upon the work non-commercially, as long
as appropriate credit is given and the new creations are licensed under the identical
terms.
Identifier
https://www.ncbi.nlm.nih.gov/pubmed/30632487
PII: 249652
Subjects
Adult
Calibration
DNA Fragmentation
Flow Cytometry
Humans
In Situ Nick-End Labeling
Male
Observer Variation
Reference Values
Reproducibility of Results
Semen Analysis
Sensitivity and Specificity
Spermatozoa
DNA fragmentation
flow cytometer
oxidative stress
sperm
TUNEL assay
Publication Status
Published
Coverage Spatial
China
Date Publish Online
2019-09