External Quality Assessment

In some countries, the establishment of concepts and programs on Quality Assurance designed for medical laboratories is mandatory. In Switzerland for instance, a Swiss Commission for Quality Assurance (QUALAB) has been created a few years ago to supervise and implement quality measures within the major laboratory specialities (clinical chemistry, haematology, immunology, microbiology and genetics). Among many others requirements, the regular participation to external quality control is mandatory. A list of analyses that are submitted to external quality control is published regularly.
Andrology and IVF laboratories are not concerned by these requirements, mainly because the insurances do not reimburse any activity associated with medically assisted procreation, with the exception of sperm preparations for artificial inseminations. The IVF laboratories are nevertheless subjected to precise legal requirements in terms of laboratory supervision and management. They necessitate a cantonal authorisation and are regularly inspected by the cantonal physician. On these occasions, the respect of the published Criteria for functioning of Medical laboratories (french, german) is often evaluated. Within these requirements, the participation to external quality controls is checked.
The use of external quality control (EQC) to assess whether subjective evaluation of gametes and embryos is performed according to accepted guidelines is essential. A comparison of individual evaluation with those of other professionals is a way of warranting precision and quality of transmitted results. It is thus in the proper interest of the IVF laboratories to become aware of Quality Management processes and to implement them even if their choice is not to go up to an ISO accreditation.