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Making it work
because someone inadvertently uses an outdated document that is somehow still in circulation.
External quality assurance
Although we have mentioned external quality assurance (EQA) several times in this book, there are limited options for IVF labs in terms of EQA programmes (EQAPs) at this time. However, one resource that does exist is a web-based commercial service called FertAid run by Jim Stanger of Newcastle, Australia (www.fertaid.com) that offers not only EQA but also operates as a training tool and an ongoing educational scheme. FertAid covers both embryology and andrology, and results can be viewed not only in comparison with a peer group, but also within a particular enrolled Center, effectively giving it an internal QC dimension as well. The major drawback that we have seen with this service is that, for now, unless you’re a very patient individual, a broadband Internet connection is the least that should be available! A variety of andrology EQA schemes exist, and it is extremely important to choose one that includes not only sound quality assurance, but a real quality improvement functionality. A scheme that only reports your results in comparison with the other participating labs, with no suggestion as to what the “right answer” was, clearly has limited value. Reference values, even if determined as “consensus” values by averaging the results from a select sub-group of internationally-recognized high calibre labs that participate in the scheme, are essential – without them the scheme is “directionless,” and there can be no quality improvement. The ESHRE Andrology Special Interest Group operates an international EQA scheme for andrology; contact Lars Bj¨orndahl by e-mail at lars.bjorndahl@kbh.ki.se for more information. For more local resources, check with your national andrology society.