A comparison of conventional and computer-assisted
semen analysis (CRISMAS software) using samples from
166 young Danish men
Anne Vested1, Cecilia H Ramlau-Hansen1, Jens P Bonde2, Ane M Thulstrup1, Susanne L Kristensen1
and Gunnar Toft1
The aim of the present study was to compare assessments of sperm concentration and sperm motility analysed by conventional semen
analysis with those obtained by computer-assisted semen analysis (CASA) (Copenhagen Rigshospitalet Image House Sperm Motility
concentration and classifies spermatozoa into three motility categories. To enable comparison of the two methods, the four motility
stages obtained by conventional semen analysis were, based on their velocity classifications, divided into three stages, comparable to
the two methods were large for all investigated parameters (P,0.001). CRISMAS overestimated sperm concentration and the
proportion of rapidly progressive spermatozoa and, consequently, underestimated the percentages of slowly progressive and
analysis, results were pooled into quarters according to date of semen analysis. CRISMAS motility results appeared more stable over
time compared to the conventional analysis; however, neither method showed any trends. Apparently, CRISMAS CASA results and
results from the conventional method were not comparablewith respect tosperm concentrationand motility analysis. Thisneeds tobe
accounted for in clinics using this software and in studies of determinants of these semen characteristics.
Asian Journal of Andrology (2011) 13, 453–458; doi:10.1038/aja.2011.14; published online 25 April 2011
Keywords: computer-assisted semen analysis; reproduction; semen analysis; sperm concentration; sperm motility
In the research field of reproductive epidemiology, sperm concentra-
tion and sperm motility are often used as predictors of reproductive
capability, since these semen parameters appear to be associated to
couple fecundability.1In epidemiological semen quality studies, it is
essential to include as many participants as possible during a short
data collection period in order togain enough powerto enableinvest-
igation of the specific hypothesis. Hence, a quick and reproducible
method of semen analysis is preferable. The method for conventional
semen analysis is a somewhat subjective and time-consuming tech-
nique, but by following World Health Organization (WHO) recom-
mendations on conventional semen analysis, results may be
comparable worldwide.2Computer-assisted semen analysis (CASA),
on the other hand, is a more objective and timesaving counterpart to
the semen sample. But how well do these two different methods
complement each other?
According to a workshop on clinical CASA in 1995, it was
reported that CASA generally tends to overestimate total sperm
counts and underestimate proportion of motile spermatozoa at very
low sperm concentrations. Additionally, CASA appears to gene-
rally underestimate total counts at high sperm concentrations
(.1003106cells ml21) and overestimate the proportion of motile
spermatozoa.3Currently there is a wide range of different CASA
software systems available; thus, in order to utilize their useful
properties, it is essential to survey the performance of the different
systems compared to the conventional semen analysis method.
Aside from a study performed by Larsen et al.,4indicating that
Copenhagen Rigshospitalet Image House Sperm Motility Analysis
System (CRISMAS) parameters can be used as predictors for male
fertility, no comparisons between conventional semen analysis and
CASA using the CRISMAS software have, to our knowledge, been
published. The aim of the present study was to compare semen ana-
lysis results obtained from 166 men, using the CRISMAS Version 4.6
CASA software with results from the conventional semen analysis.
MATERIALS AND METHODS
Recruitment of participants
that included a semen analysis. Participants were sons of a cohort of
1Danish Ramazzini Center, Department of Occupational Medicine, Aarhus University Hospital, DK-8000 Aarhus C, Denmark and
Environmental Medicine, Copenhagen University Hospital, Bispebjerg, DK-2400 Copenhagen NV, Denmark
Correspondence: A Vested Msc, PhD (email@example.com)
Received: 18 October 2010; Revised: 29 November 2010; Accepted: 11 December 2010; Published online: 25 April 2011
2Department of Occupational and
Asian Journal of Andrology (2011) 13, 453–458
? 2011 AJA, SIMM & SJTU. All rights reserved 1008-682X/11 $32.00
technical details of the CRISMAS software. We would also like to thank the
Danish Medical Research Council, the Danish Ministry of the Interior and
Health, Research Centre for Environmental Health’s Fund, the Aarhus
University Research Foundation, the Frimodt-Heineke Foundation and the
Health Research Fund of Central Denmark Region for funding the study.
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A Vested et al
Asian Journal of Andrology