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Rapid - Objective - Standardized Semen Analysis Solutions... Remember, it ALL Started with a Sperm!

RSS  Medical Electronic Systems Service and Support Updates

Chymotrypsin vs Hyaluronidase

Thursday, June 01, 2017

Here is a question that has came up:

What is the difference between Chymotrypsin and Hyaluronidase?


In the article: Stefan Stephanus du Plessis, Sheila Gokul, Ashok Agarwal. Frontiers in Bioscience, Elite, 5, 224-231, January 1, 2013, the following information on semen hyperviscosity (SHV) treatment can be found:
“Semen hyperviscosity can be treated successfully in vitro by traditional methods as well as by recently developed methods. Hyperviscous semen is commonly diluted or drawn into a hypodermic needle and forced through in order to overcome the elevated viscosity, although these methods are unlikely to be completely effective because SHV is not completely a mechanical phenomenon. More direct treatments of patients presenting with SHV include over hydration, prostatic massage, and the use of parenteral hyaluronidase (injection – my note). These methods showed limited success and have proven not to be too effective.

Less dated methods used in sperm preparation for ART procedures have been shown to improve semen and sperm parameters of infertile males. Honea et al. found that the use of limited proteolysis by using α-chymotrypsin in the treatment of SHV was effective for an in vitro setting such as IVF or IUI. Zavos et al. more recently reported that limited proteolysis by α-chymotrypsin was effective in improving the use and handling of hyperviscous semen samples, and that treatment with α-chymotrypsin assisted in the recovery of high quality sperm in greater numbers than in hyperviscous samples not treated with α-chymotrypsin.”  


Though hyaluronidase is present in semen and used in both IVF procedures and for treatment of patients (via injection), it is not recommended for semen hyperviscosity treatment in vitro because there is no evidence of effectiveness.
α-chymotrypsin was found to be an effective method for SHV in vitro treatment based on the methods listed above and years of clinical practice. 
The QwikCheck Liquefaction Kit (based on α-chymotrypsin) product insert is enclosed, demonstrating the effectiveness of the product in clinical studies.  


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Ransomware Prevention and Protection on MES Systems

Thursday, June 01, 2017
Ransomware is a form of malware that prevents or limits the use of a computer system until a sum of money has been paid.  Variants, namely “WannaCry” (or similar) were observed infecting computers belonging to individuals and businesses, which included healthcare facilities and hospitals worldwide.


1. All SQA-V and SQA-VISION systems are designed to operate “Offline”, which means they do not connect to a network or the internet. 
2. It is not recommended to use the SQA-V or SQA-VISION to run any other software, other than what is pre-installed by Medical Electronic Systems.

3. USB hard drives and flash drives not supplied directly by Medical Electronic Systems must be scanned for viruses or malware before being used to transfer data to and from the system.

4. Operating system patches and service packs must be installed by trained IT staff members using offline methods to transfer data (flash drives, discs, etc.)

5. If your IT staff recommends an operating system upgrade on V-Sperm Computers, please verify with MES support that the new operating system version will be compatible with the instrument and MES software.  Note:  SQA-VISION instruments must remain on Windows 8.1 for proper operation.

6. Medical Electronic Systems does not provide licenses for Operating System upgrades.  In the case of an Operating System upgrade to V-Sperm computers, IT staff must purchase, install and license the operating system directly.  MES will assist in reloading all necessary software pertaining to the system.

7. New V-Sperm computers with supported Operating Systems are available for purchase directly through Medical Electronic Systems.


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Updated QwikCheck QC Beads Storage Recommendations

Friday, April 28, 2017

In order to ensure consistent product performance Medical Electronic Systems is now recommending that opened QwikCheck Bead QC Kits be stored @ 2-8°C (36-46°F). The expiration date assumes that QwikCheck beads are stored in their original containers and tightly capped to prevent evaporation. QwikCheck beads are stable and show no loss of expected performance characteristics after transport/storage over a period of 72 hours at the temperature range of -20°C to +37°C (-4°F to +99°F).


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Precision Vs Accuracy Example

Sunday, April 23, 2017

It is important to understand the relationship and difference between Precision and Accuracy.  Both are important, and both showcase different aspects of a Validation or Comparison study. The image below provides a very nice visual representation:

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No Lubricants During Collection

Wednesday, February 15, 2017
It is highly recommended that no lubricants are used during sample collection if the sample is to be run on the SQA platform.  As you can see in the image below, lubricants can leave an oil looking substance in the seminal plasma which may potentially interfere with the automated analysis performed by the SQA-V and SQA-Vision.  Keep it dry and Keep it Accurate!  Remember, it ALL Started with a Sperm!

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The Importance of Semen Sample Liquefaction and Viscosity for Semen Analysis

Thursday, June 16, 2016



In addition to the obvious issues with sample loading in the SQA testing capillary, would concentration readings be higher or lower in a sample which has not fully liquefied?


1.  Running a non-liquefied (or viscous) semen sample will most probably result in inaccurate results for the following reasons:

2.  The sample is poorly represented. In a fully liquefied sample, sperm cells are evenly spread throughout the semen volume and this makes the sample taken for analysis more representative of the entire ejaculate.

3.  Concentration and other semen parameters may vary in both directions in the case of running a viscous sample.

4.  Motility may be lower in viscous samples.

According to the WHO 5th manual, each highly viscous or non-liquefied semen sample should be treated to bring it to normal viscosity prior to testing (WHO 5th ed. manual, p. 13-15;)

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Minimum Sample Volume Requirements for SQA Systems and Dilution Options

Saturday, May 28, 2016
Automated semen assessment using the SQA-V / Vision requires a pre-defined sample volume to be aspirated into the testing capillary in order to generate a full semen analysis report. The volume of the SQA testing capillary is 0.5 ml and this volume provides sufficient statistical representation of the entire ejaculate, resulting in a high level of precision using the automated SQA analyzer.


Based on the required semen sample testing volume of 0.5 mL, it is recommended to fill the entire testing capillary with a semen sample without any dilution if the ejaculate volume is >= 0.5 mL. Sometimes though the ejaculate volume may be less than 0.5 mL. The dilution mode of the SQA-V and Vision can be used in this case as follows: If the semen sample volume is >= 0.3 mL, dilute the sample using the QwikCheck Dilution media two times (1:2 or 1+1). For example, 0.3 mL of semen sample is mixed with 0.3 mL of diluent resulting in a volume of 0.6 mL. This will provide an adequate sample volume to aspirate into the SQA testing capillary and the SQA software automatically compensates for the dilution and will provide a full report, no calculations are required by the operator.


Based on the sample volume, M.E.S. recommends the following approach to testing the sample:
• Semen Volume >= 0.5 mL - No dilution is required
• Semen Volume >= 0.3 mL and < 0.5 mL - Dilution 1:2 (1+1) using the QwikCheck Dilution kit
• Semen Volume < 0.3 mL - Manual assessment [microscope or Vision Manual Mode or Vision Semi-automated Mode (10 µL automated testing + 10 µL manual motility assessment)]


• WHO laboratory manual for the examination and processing of human semen - 5th ed., WHO 2010.
• SQA-V GOLD User Guide Version 2.60 I-Button
• SQA-Vision User Guide Version 104.13.2





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2016 CAP Proficiency Instructions for SQA Systems

Wednesday, April 27, 2016




For All SQA-V and SQA-VISION Systems Version 2.45 and above | UPDATE: April 27th, 2016



The College of American Pathologists ( provides a nationwide proficiency challenge for automated methods of semen analysis.  These results are peer reviewed against other SQA users providing an objective and efficient way to maintain proficiency.  MES recommends this survey as an unbiased appraisal of user proficiency and system performance. 


NOTE: The CAP proficiency material should first be run as Stabilized Sperm in the “Control” mode and re-run in the Test New Patient “Fresh” Mode if a result of 0.0 is reported in Stabilized Sperm Control mode.



  • From the main menu of the SQA-V/SQA-V Gold/Spermalite select: SERVICE > SERVICE DATA.
  • From the V-Sperm computer, navigate to SET UP > SQA-V > SQA-V DEFAULTS and click “CONTINUE”.  You will now see a set-up screen displayed on the PC.
  • On the bottom half of the setup screen, select the “STABILIZED SPERM” option and enter the following for Level 1 and Level 2:    
    • Lot Number = Your Sample Reference # | Target = 50 | Range = 50 | Date = Today’s date.
    • Click “APPLY” and wait a few moments for the information to transfer to the SQA-V.
    • NOTE: Do not forget to change your defaults back to Latex Beads after running your CAP sample!



  1. From the MAIN MENU of the SQA select: RUN CONTROLS > LEVEL 1 and allow system to calibrate.
  2. Mix the sample well by aspirating it in and out 10 times with a transfer pipette.  Avoid bubbles!
  3. Load the SQA-V testing capillary and check CLOSELY for bubbles then wipe the capillary tip clean.
  4. Insert capillary into the testing chamber when prompted to do so.
  5. If a sample result of 0.0 is received, re-run the sample as a FRESH sample.
  6. To Re-Run sample as FRESH, select “Test New Patient” from the main menu and enter the CAP sample number as the Patient ID.
  7. All other entries on the first screen may be skipped.
  8. On the second screen select “FRESH” under sample type and < 1 M/mL for WBC CONC. (all other entry fields may be skipped).
  9. Select YES when asked if sample is sufficient for complete testing > 0.5 M/mL.
  10. Allow system to calibrate and insert the capillary when prompted.
  11. Report the results received.
  12. Repeat Steps 1 – 11 for the second CAP proficiency material level.





  1. From the MAIN MENU of the VISION PC, select SETTINGS > PROIFICIENCY. 
  2. Enter a SAMPLE ID, DATE, and a NOTE (if necessary).
  3. Click SAVE.


  1. Select QC / PROFICIENCY from the main MENU and touch TEST NOW on the desired option.
  2. Mix the sample well by aspirating it in and out 10 times with a transfer pipette.  Avoid bubbles!
  3. Load the SQA-V testing capillary and check CLOSELY for bubbles then wipe the capillary tip clean.
  4. Insert capillary into the testing chamber when prompted to do so.
  5. Report the results received.
  6. Repeat steps 1 through 5 for all samples.



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SQA-VISION Training Outline Now Available

Thursday, March 31, 2016

Click the image below for a screen shot overview of the SQA-VISION instrument.  The document may be used as a training reference tool for MES distributors and end users looking to train new staff members.  Remember, it ALL Started with a Sperm!


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What is the clinical relevance of distinguishing spermatids from WBCs during a semen analysis?

Monday, February 29, 2016

Answer: Leukocytes, predominantly polymorphonuclear leukocytes (PMN, neutrophils), are present in most human ejaculates (Tomlinson et al., 1993; Johanisson et al., 2000). They can sometimes be differentiated from spermatids and spermatocytes in a semen smear stained with the Papanicolaou procedure. Differentiation is based on differences in staining coloration, and on nuclear size and shape (Johanisson et al., 2000). Polymorphonuclear leukocytes can easily be confused morphologically with multinucleated spermatids, but stain a bluish colour, in contrast to the more pinkish colour of spermatids (Johanisson et al., 2000). Nuclear size may also help identification: monocyte nuclei exhibit a wide variation in size, from approximately 7 µm for lymphocytes to over 15 µm for macrophages. These sizes are only guidelines, since degeneration and division affect the size of the nucleus.  There are several other techniques for quantifying the leukocyte population in semen. As peroxidase-positive granulocytes are the predominant form of leukocytes in semen, routine assay of peroxidase activity is useful as an initial screening technique (Wolff, 1995; Johanisson et al., 2000) / (WHO 5th ed. manual, p. 102).

The test can be useful in distinguishing polymorphonuclear leukocytes from multinucleated spermatids, which are peroxidase-free (Johanisson et al., 2000).  (WHO 5th ed. manual, p. 103).

The total number of peroxidase-positive cells in the ejaculate may reflect the severity of an inflammatory condition (Wolff, 1995). This is obtained by multiplying the concentration of peroxidase-positive cells by the volume of the whole ejaculate.  Excessive numbers of leukocytes in the ejaculate (leukocytospermia, pyospermia) may be associated with infection and poor sperm quality.  Leukocyte-dependent damage to spermatozoa depends on the total leukocyte number in the ejaculate and the number of leukocytes relative to the number of spermatozoa.  Leukocytes can impair sperm motility and DNA integrity through an oxidative attack.  (WHO 5th ed. manual, p. 107).

Therefore distinguishing spermatids from WBCs during a semen analysis is of great clinical value. Using the QwikCheck Test Strips for WBC detection allows this differentiation, as this kit is specific for leukocyte (granulocyte) detection.

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