ABSTRACT
Study question How does computer-assisted semen analysis (CASA) (Lenshooke, LOGIXX) and at-home sperm testing (ExSeed) compare with manual methodology assessment of male fertility based on WHO criteria (5thEdition);a three-method comparison study. Summary answer All methods showed good agreement for concentration and limited agreement for motility highlighting the need for further development of alternatives to manual assessment. What is known already Several studies have shown good correlation between CASA systems and laboratory-based manual semen analysis, but only a few have carried out a three-way comparison study. One of which showed positive correlation with motility and concentration between a smartphone-based semen analysis and laboratory-based CASA system and positive correlation between concentration and motility between the smartphone-based CASA system and microscopic-based results. The at-home sperm test kit may play a role in motivating infertile males to visit clinics for early diagnosis and also reducing the need for multiple visits to the fertility clinic for repeat semen analyses. Study design, size, duration Fifty patients (between 29 and 56 years) attending a fertility clinic were included in the study between September 2021 to December 2021. Semen samples were split into 3 aliquots and evaluated using manual semen assessment (MSA) according to the WHO 5th Edition (2010) guidelines, the ExSeed Home Sperm Test (HST) and the LensHooke® X1 PRO Semen Quality Analyzer (CASA). Participants/materials, setting, methods The semen samples were collected from fifty participants at CARE Fertility Tunbridge Wells. The samples were placed in an incubator at 37°C for 30 minutes to liquefy. After liquefaction, sperm concentration, total motility, total motile sperm count (TMSC) and normal morphology were evaluated. Spearman’s Rank correlations (>0.7) and Chi-squared tests were used and the p-value < 0.05 was considered as statistically significant. Main results and the role of chance All variables were highly significantly (p < 0.0002) positively correlated between all 3 methods. The greatest correlations were obtained for sperm concentration (CASA/HST: r = 0.826;MSA/HST: r = 0.870;MSA/CASA: r = 0.871) and TMSC (MSA/CASA: p = 0.792;CASA/HST: r = 0.800;MSA/HST: r = 0.854). Correlations for motility were markedly lower (MSA/HST: r = 0.611;CASA/HST: r = 0.717;MSA/LCASA: r = 0.750). The lowest correlation was found for morphology (MSA/CASA: r = 0.500). The HST device does not determine morphology. As compared to MSA, using the HST device agreement for normal or low sperm concentration (≥15 × 106/mL or < 15 × 106/mL respectively) was identified in 84.3% of the cases, whereas 94.0% with CASA. The agreement between CASA and HST was 82.0%. For total motility ≥ or < 40%, the agreements were 68.0% (CASA/HST), 56.9% (MSA/HST) and 82.0% (MSA/CASA), respectively. For the identification of patients with normal morphology >4%, the agreement between MSA and CASA was 30%. Limitations, reasons for caution The small sample size was 50 cases. The home testing device does not assess morphology. Furthermore, it is difficult to ascertain whether a consumer would carry out the analysis with this device with the same accuracy as an embryologist. Wider implications of the findings The need for repeated semen analyses, the effect of the COVID-19 pandemic and the discomfort some patients feel in a clinical setting, necessitate the need for evaluation of novel semen analysis approaches. These emerging technologies have potential to be more patient friendly, convenient and efficient than standard semen assessment methods. Trial registration number not applicable
ABSTRACT
Objective: To measure incidence of COVID-19 vaccine breakthrough infections among health care workers vaccinated with both doses of Sinopharm Vaccine. Study Design: Prospective cohort study. Place and Duration of Study: All Military Institutes of Pakistan, from Feb to Jun 2021. Methodology: Detailed surveillance mechanism was developed before the start of Health Care Workers vaccination in Pakistan Military to report any PCR positive COVID-19 infection post vaccination. Among 39512 health care workers vaccine-ted with both doses of COVID-19 vaccine;those who developed COVID-19 infection ≥14 days post 2nd dose were included in the study. Total 124 participants till 30 Jun 2021 fulfilled the criteria of COVID-19 vaccine breakthrough infection and were analyzed. Results: Mean age of the participants was 38.8 ± 11 years. Males were 69.4% while females were 30.6%. Median duration from 2nd dose to development of COVID-19 vaccine breakthrough infection was 36.5 days (IQR, 26-62). Asymptomatic/mild infections were reported among 94.4% and only 5.6% had moderate disease. No severe/critical disease requiring oxygen supplementation or ventilator support was observed. Recovery rate was 100% with no mortality. There was no significant statistical association of age, gender, job category with COVID-19 vaccine breakthrough infection (p>0.05). Conclusion: Vaccines remain an important weapon in the battle against COVID-19. No vaccine is 100% effective against all strains of COVID-19;however among the completely vaccinated health care workers less severe disease was observed. There was no mortality. © 2021, Army Medical College. All rights reserved.