/*
   
   Function List:
   swTechnote
      Used to return a description for note "n"
*/


function swTechnote(n) {
   var descrip = new Array();
   descrip[1]="Dear Sperm Wizard:<br />I love your quality control for motility, but we need a way to document our motility analysis for progressive motility. Can you help?<br /><br />-Helen in Hematology"+"</p>"+"<p>"+"Dear Helen:<br />Absolutely!  Some of our customers have requested this recently, so we've added it to our existing Sperm Motility Quality Control.  Because you asked for it, our videos are now assayed for both % Total Motility and % Progressive Motility.<br />Of course, trying to determine progression by counting moving sperm is both difficult and very subjective.  I recommend a more objective method: load a sperm counting chamber and count all the immotile and non-progressive sperm, then immobilize part of the sample, load another chamber and count the total.  The difference gives the number of progressively motile sperm. The sample can be immobilized either in a heat bath or with my Sperm Immobilizing Diluent.<br />All of our products are backed by the toll-free expertise of the Semen Analysis Experts&trade;.  Our experts are always on hand for any semen analysis questions you may have!<br />-The Sperm Wizard";
   descrip[2]="Dear Sperm Wizard:<br />Our lab needs tools for classifying sperm morphology. We're all using the same reference, but I think we're performing the test differently! How can I find out?<br />-Liz in the Laboratory"+"</p>"+"<p>"+"Dear Liz:<br />Try this product: my VirtuMorf&trade; Virtual Semen Morphology Smear, a high resolution 110x170 color print of a Pap-stained semen smear. Like a semen smear, the VirtuMorf&trade; is analyzed to determine the percent of sperm with normal forms. The format makes it easy to compare classification competency.  Our approach has revolutionized sperm morphology proficiency testing/ training and forms the basis of our revised Sperm Wizard Sperm Morphology Training Program. Like our QC smears, the VirtuMorf&trade; smears have Levy-Jennings charts for % normal with both WHO 3rd and 4th/Strict methods and a discussion of classification rationale for ten numbered sperm. The product is backed by the toll-free expertise of the Semen Analysis Experts&trade;.<br />- The Sperm Wizard";
   descrip[3]="<h3>Tech Notes: Who's Who In Sperm Morphology</h3>"+"We recently got a call from a distressed lab director who received notification that his lab failed its sperm morphology proficiency test offered by a major proficiency provider.  He reported results for Strict Classification but was surprised to see that it was reported separately from WHO 4th (1999) Edition Classification.  Why the surprise?  Because these two systems are the same!  In the 4th Edition of the WHO Laboratory Manual for the Examination of Human Semen and Sperm-Cervical Mucus Interaction), Section 2.5.4 clearly references the Strict criteria described by Menkveld and Kruger from Tygerberg, South Africa.<br /><br />More of a surprise to our unhappy lab director was that the two groups, Strict and WHO 4th Š both synonymous for the same classification criteria -- had very different results!  Had he listed WHO 4th as his reference, his results would have been acceptable.  The provider also combined ASCP, WHO 3rd edition and WHO 4th, all with very different standards of normal and thus, reference ranges. No wonder the range of answers encompassed the entire assay range, 0 107%. (Note that the provider reported upper ranges above 100% normal, a statistically valid but biologically impossible answer.)<br /><br />Many technologists tell us they are confounded by the multiple systems used for morphology classification.  Since each of the four editions of the WHO Manual recommends a different system and reference limits, they can be mistaken for each other, especially when a specific edition number isn't specified.  But other lab scientists devised classification systems, some of which are the origin of the various WHO systems, some of which are variants of them.  Sometimes multiple authors report data with classification systems, giving their name or their cities name to the system.  The Strict Classification is the best example, as it also is called Kruger Morphology, Tygerberg Classification and of course, WHO 4th.<br /><br />There are a number of morals to this interesting and true-life story.  First, make sure that you know which classification scheme you use for sperm morphology as well as all of its synonyms. Our Sperm Confirm Atlas of Sperm Morphology and Semen Cytology compares classification with five systems in common use and describes their origins and rationales.   Second, make sure your PT provider knows which classification systems should be combined to stratify data.  Does your provider understand the complexity of semen analysis field?  Do they provide state-of-the-art virtual smears? Feel free to call us for referrals.";
   descrip[4]="<h3>Tech Notes: Sperm Morphology References</h3>"+"Sperm morphology is a highly predictive measure of fertility potential and can be the primary indicator to a specific therapeutic path.  Morphology also is an important measure of environmental and occupational toxic exposure.  The existence of many different classification schemes with different normal cutoffs makes sperm classification very difficult and confusing.  Often, outdated schemes (e.g. ASCP, McLeod, and WHO 2nd Edition) are used that have little or no informative value for the physician receiving results.  In addition, a frequent mistake is to confuse the procedure reference for the classification reference.<br /><br />A procedure reference such as WHO 3rd or 4th Edition is needed to establish the actual procedure of performing a morphology evaluation.  This will cover steps such as preparing the smear, staining, and the number of sperm to evaluate.  A reference atlas, on the other hand, is used to determine the criteria for actual classification of the cells.  An atlas will have clear photographs of the different morphological types, with descriptions specific to each classification system.  For example, photos labeled for normal and abnormal types in Adelman & CahillÕs reference atlas for ASCP will not be accurate for classifying normal and abnormal types under WHO 3rd.  In our September 2007 Proficiency Challenge, we asked participants to report both the classification system and the reference atlas used.  We found that several use the wrong atlas for their scheme, and some reported that they use no reference at all!<br /><br />To help labs learn a modern system, Fertility Solutions Inc. developed teaching and competency validation tools.  Our Sperm Confirm&trade; Human Sperm Morphology and Semen Cytology Atlas contains images of 88 cells that help you correctly identify sperm defects and non-sperm cells found in semen.  The Sperm Confirm&trade; Atlas contains a separate classification for each image by the five major systems, both current and outdated, with a discussion of differences in their classifications to help update your lab to a current system.";
   descrip[5]="<h3>Tech Notes: Sperm Morphology Classification Made Simpler</h3>"+"Sperm morphology remains one of the most difficult areas of semen analysis.  It relies on subjective analysis of the appearance of stained sperm, an area where training is usually minimal.  The many different classification systems in use make for confusion about how to classify a sperm as normal.  In particular, many technologists are unsure of the differences between the two most commonly used systems - WHO 3rd Edition (recommended for all general fertility screening) and Strict/WHO 4th (mainly used in IVF settings).  The primary difference is in whether borderline sperm are defined as normal (WHO 3rd) or abnormal (Strict/WHO 4th).<br /><br />How do you know what is classified as borderline?<br /><br />"+"<table border='1' width='700'>"+"<th>"+"Normal"+"</th>"+"<th>"+"Borderline variations permitted:"+"</th>"+"<tr>"+"<td>"+"Oval head"+"</td>"+"<td>"+"vacuoles if < 30% of the head"+"</td>"+"</tr>"+"<tr>"+"<td>"+"acrosomal region, 40-70% of head"+"</td>"+"<td>"+"minor tapering of the head"+"</td>"+"</tr>"+"<tr>"+"<td>"+"no neck, midpiece or tail defects"+"</td>"+"<td>"+"acrosome slightly larger or smaller"+"</td>"+"</tr>"+"<tr>"+"<td>"+"CD < 1/3 the head"+"</td>"+"<td>"+"head shape/size slightly abnormal"+"</td>"+"</tr>"+"<tr>"+"<td>"+"No more than four vacuoles"+"</td>"+"<td>"+"midpiece slightly thickened"+"</td>"+"</tr>"+"</table><br />WHO 3rd Normal: normal + borderline<br />Strict/WHO 4th Normal: normal only<br /><br />For examples and more information, see our Sperm Confirm Atlas of Human Sperm Morphology and Semen Cytology.  We also offer the Sperm Morphology Quality Controls to meet your daily QC requirements, as well as several other training and competency testing programs.  Our products are all backed by the knowledge of The Semen Analysis Experts&trade; at Fertility Solutions - call us anytime with questions!";

   return descrip[n];
}