{"id":31070,"date":"2019-05-16T17:54:55","date_gmt":"2019-05-16T15:54:55","guid":{"rendered":"https:\/\/www.micropticsl.com\/spermogramme-automatise-enfin-blog\/"},"modified":"2026-06-29T14:39:44","modified_gmt":"2026-06-29T12:39:44","slug":"spermogramme-automatise-enfin-blog","status":"publish","type":"post","link":"https:\/\/www.micropticsl.com\/es\/spermogramme-automatise-enfin-blog\/","title":{"rendered":"Le spermogramme automatis\u00e9 au laboratoire, enfin !"},"content":{"rendered":"
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Dans l\u2019exploration du couple infertile, le spermogramme et spermocytogramme sont toujours les examens de 1\u00e8re intention. La technique de r\u00e9f\u00e9rence reste la technique manuelle et la plupart des laboratoires d\u2019analyse m\u00e9dicale peuvent r\u00e9aliser ces examens, m\u00eame si souvent les prescripteurs pr\u00e9f\u00e8rent qu\u2019ils soient r\u00e9alis\u00e9s dans un laboratoire exp\u00e9riment\u00e9 en raison des variations inter-laboratoires importantes.<\/p>\n

Dans notre laboratoire<\/a> nous avons \u00e9valu\u00e9 le Sperm Class Analyser (SCA, Microptic*, Espagne)<\/a> en le comparant \u00e0 la technique de r\u00e9f\u00e9rence manuelle. Nous avons aussi r\u00e9alis\u00e9 une adaptation technique pour proposer pour la 1\u00e8re fois l\u2019analyse morphologique automatis\u00e9e selon la classification de David modifi\u00e9e par Auger.<\/p><\/blockquote>\n

Des \u00e9tudes multicentriques ont montr\u00e9 pour le param\u00e8tre concentration en spermatozo\u00efdes, l\u2019un des moins subjectifs des param\u00e8tres analys\u00e9s, des coefficients de variations (CV) inter-laboratoires variant de 21% \u00e0 80% (Brito et al., 2016). Ces variations, principalement li\u00e9es aux \u00e9carts inter-op\u00e9rateurs, nous ont conduits \u00e0 nous orienter vers l\u2019automatisation de l\u2019analyse du spermogramme. Si l\u2019automatisation est tr\u00e8s largement utilis\u00e9e dans les laboratoires pour la biologie polyvalente elle n\u2019a que peu investi le champ de la spermiologie. Des appareils CASA (Computer Assisted Sperm Analysis) sont apparus sur le march\u00e9 d\u00e8s 1985 avec des \u00e9volutions techniques r\u00e9guli\u00e8res (revue dans Amann & Waberski, 2014) mais leurs r\u00e9sultats sont assez discordants et pour la morphologie, leurs logiciels sont souvent adapt\u00e9s \u00e0 une classification diff\u00e9rente de celle majoritairement utilis\u00e9e en France. L\u2019arriv\u00e9e sur le march\u00e9 d\u2019automates plus adapt\u00e9s, la mise en place de l\u2019accr\u00e9ditation avec son cort\u00e8ge de contr\u00f4les de qualit\u00e9 et la n\u00e9cessit\u00e9 de voir diminuer les variations inter- et intra-laboratoires ouvrent une place \u00e0 ces automates. Dans notre laboratoire nous avons \u00e9valu\u00e9 le Sperm Class Analyser (SCA, Microptic*, Espagne) en le comparant \u00e0 la technique de r\u00e9f\u00e9rence manuelle. Nous avons aussi r\u00e9alis\u00e9 une adaptation technique pour proposer pour la 1\u00e8re fois l\u2019analyse morphologique automatis\u00e9e selon la classification de David modifi\u00e9e par Auger (Auger et al., 2016).<\/p>\n

Le syst\u00e8me SCA est compos\u00e9 d\u2019un microscope \u00e9quip\u00e9 d\u2019une cam\u00e9ra num\u00e9rique, d\u2019une platine chauffante motoris\u00e9e, et d\u2019un logiciel d\u2019analyse d\u2019images (Microptic SL*) \u00e9quip\u00e9 d\u2019un filtre analytique qui permet d\u2019\u00e9liminer les \u00e9v\u00e9nements d\u2019analyse incoh\u00e9rents (d\u00e9bris cellulaires, t\u00eates ou flagelle isol\u00e9s).<\/p>\n

L\u2019analyse automatis\u00e9e de la concentration, mobilit\u00e9, vitalit\u00e9 et morphologie compar\u00e9e \u00e0 la m\u00e9thode manuelle retrouvent des r\u00e9sultats tr\u00e8s similaires avec la m\u00e9thode manuelle (pour chaque param\u00e8tre au moins 30 spermes ont \u00e9t\u00e9 \u00e9valu\u00e9s). Ces comparaisons ont \u00e9t\u00e9 r\u00e9alis\u00e9es sur un grand nombre d\u2019\u00e9chantillons de patients pour couvrir toutes les situations normales et pathologiques de chaque param\u00e8tre et pour tenir compte aussi de la grande variabilit\u00e9 des \u00e9chantillons de sperme pour un m\u00eame patient, ce qui est une difficult\u00e9 particuli\u00e8re de cet analyse. Ces 2 m\u00e9thodes sont donc comparables (distribution normale des populations et comparaison par le calcul de la droite de r\u00e9gression par la m\u00e9thode des moindres carr\u00e9s).<\/p>\n

De plus, pour chacun des param\u00e8tres \u00e9tudi\u00e9s, les CV de r\u00e9p\u00e9tabilit\u00e9 diminuent nettement avec l\u2019analyse automatis\u00e9e. Par exemple pour un sperme normal, avec l\u2019analyse manuelle et automatis\u00e9e on retrouve respectivement un CV de 9,0% et 4,4% pour la concentration de spermatozo\u00efdes, de 7,3% et 2,4% pour la vitalit\u00e9 et enfin de 11,4% et 4,1% pour la morphologie.<\/p>\n

Les CASA de derni\u00e8re g\u00e9n\u00e9ration sont devenus des outils pr\u00e9cieux pour l\u2019analyse en routine des principaux param\u00e8tres du spermogramme, leur analyse est rapide et fiable. L\u2019apprentissage \u00e0 l\u2019utilisation du CASA est rapide pour une technicienne qualifi\u00e9e en spermiologie manuelle. Toutefois cette technologie ne remplacera pas compl\u00e8tement l\u2019expertise manuelle notamment dans le cas des valeurs tr\u00e8s basses en concentration o\u00f9 l\u2019automate atteint ses limites. Le maintien de comp\u00e9tence des techniciennes en spermiologie manuelle devra \u00eatre maintenu dans les laboratoires.<\/p>\n

L\u2019utilisation du syst\u00e8me CASA, malgr\u00e9 son cout encore \u00e9lev\u00e9, apporte au laboratoire de biologie m\u00e9dicale une am\u00e9lioration de la robustesse de ses r\u00e9sultats pour une analyse qui a d\u00e9j\u00e0 des plages de normalit\u00e9 tr\u00e8s grandes (WHO, 2010). C\u2019est aussi la premi\u00e8re fois qu\u2019un automate de ce type peut rendre des r\u00e9sultats de morphologie des spermatozo\u00efdes selon la classification de David modifi\u00e9e par Auger (Auger et al., 2016).<\/p>\n

En savoir +<\/h2>\n
    \n
  • Amann RP & Waberserski D. (2014) Computer-assisted sperm analysis (CASA): capabilities and potential developments<\/em>. Theriogenology 81, 5\u201317.<\/li>\n
  • Auger J, Jouannet P & Eustache F. Another look at human sperm morphology<\/em>. (2016) Hum Reprod 31, 10\u201323.<\/li>\n
  • Brito LFC, Althouse GC, Aurich C, Chenoweth PJ, Eilts BE, Love CC, Luvoni GC, Mitchell JR, Peter AT, Pugh DG & Waberski D. (2016) Andrology laboratory review: evaluation of sperm concentration<\/em>. Theriogenology 85, 1507-1527.<\/li>\n
  • World Health Organization. (2010) WHO laboratory manual for the examination and processing of human semen<\/em> (5th edn), WHO Press, Geneva.<\/li>\n<\/ul>\n

     <\/p>\n

    Dr. Andr\u00e9 Force et Dr. Benoit Schubert<\/strong><\/p>\n

    <\/div><\/div><\/div>\n<\/div>\n

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