Sperm counts have been linked to several fertility outcomes making them an essential parameter of semen analysis. It has become increasingly recognised that Computer-Assisted Semen Analysis (CASA) provides improved precision over manual methods but that systems are seldom validated robustly for use. The objective of this study was to gather the evidence to validate or reject the Sperm Class Analyser (SCA) as a tool for routine sperm counting in a busy laboratory setting. The criteria examined were comparison with the Improved Neubauer and Leja 20-μm chambers, within and between field precision, sperm concentration linearity from a stock diluted in semen and media, accuracy against internal and external quality material, assessment of uneven flow effects and a receiver operating characteristic (ROC) analysis to predict fertility in comparison with the Neubauer method. This work demonstrates that SCA CASA technology is not a standalone 'black box', but rather a tool for well-trained staff that allows rapid, high-number sperm counting providing errors are identified and corrected. The system will produce accurate, linear, precise results, with less analytical variance than manual methods that correlate well against the Improved Neubauer chamber. The system provides superior predictive potential for diagnosing fertility problems.

Purpose: Caffeine is frequently used by athletes as an ergogenic aid. Various alternate forms of caffeine administration are available, which may produce different effects. This investigation compares the effects of different forms of caffeine supplementation on 5-km running performance, and the relationship between athlete ability and degree of enhancement attained. Methods: Fourteen amateur runners completed a series of self-paced outdoor time trials following unknown ingestion of a placebo (P) or one of 3 alternate forms of caffeine supplement. Trials were randomized in a crossover design with caffeine (approximately 3–4.5 mg·kg−1) administered 15 minutes before each trial via chewing gum (CG), dissolvable mouth strips (CS), or tablet (CT). Results: Compared with P, all caffeine supplements led to worthwhile enhancements in running performance with a mean (±95% confidence limit) overall effect across all supplements of 1.4% ± 0.9%. Individual caffeine treatment effects (CG = 0.9% ± 1.4%, CS = 1.2% ± 1.0%, and CT = 2.0% ± 1.1%) were not significantly different (P > .05) from each other; however, CT trials produced the largest gain and was significantly different (P = .02) compared with P. There was no significant difference in heart rate or rate of perceived exertion across the performance trials. The magnitude of caffeine enhancement was also strongly correlated (r = .87) with no-treatment performance time. Conclusions: The findings showed that irrespective of delivery form, moderate dose of caffeine supplementation produces worthwhile gains in 5-km running performance compared with a P. Furthermore, the magnitude of caffeine enhancement is highly individualized, but it appears related to athlete performance ability.

Sperm cryopreservation is the only method currently available that offers men with cancer insurance against sterilising iatrogenic treatments. We carried out two cohort and cross-sectional audits to identify trends with sperm cryopreservation referral rates and sample usage rates for men diagnosed with cancer and who banked sperm at The Andrology Laboratory, Hammersmith Hospital, Imperial College NHS Trust. These retrospective audits revealed that a total of 4362 men with cancer successfully banked sperm between 1976 and 2013. Truncating the dataset to 2009 to allow for lag times between storage and use, the overall sample usage rate for cancer patients was 6.0% with 75 live births. Increased median age at referral influences the cancer profile of men seen at the bank, which is highlighted by a disproportionate rise in the number of men with prostate cancer. Among men who use banked sperm, a large rise in the use of intracytoplasmic sperm injection has occurred over time. The number of patients requiring the service is sharply increasing year on year as are the number of patients who go on to use their sample in assisted conception. The historical use rates of frozen sperm are likely to be significant underestimations of future use.

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