Influence of Sperm Morphology on the Outcome of Assisted Reproductive Technique—Intracytoplasmic Sperm Injection Cycles: A Retrospective Analysis
K Muthukumar, PR Preetha
Citation Information :
Muthukumar K, Preetha P. Influence of Sperm Morphology on the Outcome of Assisted Reproductive Technique—Intracytoplasmic Sperm Injection Cycles: A Retrospective Analysis. Int J Infertil Fetal Med 2015; 6 (3):122-127.
The aim of this study was to evaluate the influence of spermatozoa morphology on ICSI cycle outcome parameters in couples with male factor infertility.
University-level tertiary care center.
Patients and methods
One hundred and forty-eight couples with male factor infertility who had undergone intracytoplasmic sperm injection (ICSI) cycle from 2010 to December 2012 were included in this analysis. The semen samples of the male partners were classified according to the three predictive categories of the Tygerberg strict criteria: excellent prognosis (> 14% morphologically normal spermatozoa), good prognosis (5–14%) and poor prognosis (< 5%).
Main outcome measures
The primary outcome was the embryo quality rate.
Patients in the poor prognosis subgroups exhibited deficits in spermatozoa concentration, motility and total motile fraction. The variations in the outcome parameters of fertilization rate, embryo development rate and embryo quality did not correlate with sperm morphology.
Our study suggests that Kruger's strict morphology criteria of the fresh semen sample is not a good predictor for the ICSI cycle outcome.
How to cite this article
Preetha RP, Kamath MS, Aleyamma TK, Muthukumar K. Influence of Sperm Morphology on the Outcome of Assisted Reproductive Technique-Intracytoplasmic Sperm Injection Cycles: A Retrospective Analysis. Int J Infertil Fetal Med 2015;6(3):122-127.
Sperm morphologic features as a prognostic factor in in vitro fertilization. Fertil Steril 1986 Dec;46(6):1118-1123.
Predictive value of normal sperm morphology in intrauterine insemination (IUI): a structured literature review. Hum Reprod Update 2001 Sep-Oct;7(5):495-500.
A logistic regression model including DNA status and morphology of spermatozoa for prediction of fertilization in vitro. Hum Reprod 1998 May;13(5):1235-1239.
Sperm morphology as diagnosed by strict criteria: probing the impact of teratozoospermia on fertilization rate and pregnancy outcome in a large in vitro fertilization population. Fertil Steril 1994 Sep;62(3):559-567.
Sperm characteristics and outcome of human assisted fertilization by subzonal insemination and intracytoplasmic injection. Fertil Steril 1993 Apr;59(4):826-835.
The effect of sperm parameters on the outcome of intracytoplasmic sperm injection. Fertil Steril 1995 Nov;64(5):982-986.
The result of intracytoplasmic sperm injection is not related to any of the three basic sperm parameters. Hum Reprod 1995 May;10(5):1123-1129.
Ultrastructure of gametes and intracytoplasmic sperm injection: the significance of sperm morphology. Hum Reprod 1998 Apr;13 Suppl 1:99-106.
In vitro fertilizing capacity of the human spermatozoa with the use of zona-free hamster ova: interassay variation and prognostic value. Fertil Steril 1982 Apr;37(4):565-572.
The outcome of intracytoplasmic sperm injection is unrelated to ‘strict criteria’ sperm morphology. Hum Reprod 1996 May;11(5):1019-1022.
Isolated teratozoospermia does not affect in vitro fertilization outcome and is not an indication for intracytoplasmic sperm injection. Fertil Steril 2007 Dec;88(6):1583-1588.
Factors of importance for the establishment of a successful program of intracytoplasmic sperm injection treatment for male infertility. Fertil Steril 1995 Apr;63(4):828-837.
Special applications of intracytoplasmic sperm injection: the in.uence of sperm count, motility, morphology, source and sperm antibody on the outcome of ICSI. Hum Reprod 1998 Apr;13 Suppl 1:143-154.
Semen quality: is there a paternal effect on pregnancy outcome in in-vitro fertilization/intra- cytoplasmic sperm injection? Hum Reprod 1998 Aug;13(8):2161-2164.
Sperm morphology evaluated by computer (IVOS) cannot predict the fertilization rate in vitro after intracytoplasmic sperm injection. Fertil Steril 1998 Mar; 69(3):564-568.
Pregnancy course and health of children born after ICSI depending on parameters of male factor infertility. Hum Reprod 2003 Feb;18(2):351-357.
A prospective randomized trial of blastocyst culture and transfer in vitro fertilization. Hum Reprod 1998 Dec; 13(12):3434-3440.
Istanbul consensus workshop on embryo assessment: proceedings of an expert meeting. Reproductive Bio Medicine Online 2011;22:632-646.
Pregnancy outcome of in vitro fertilization/intracytoplasmic sperm injection with profound teratospermia. Fertil Steril 2004 Oct;82(4):847-849.
Predictive value of normal sperm morphology: a structured literature review. Hum Reprod Update 1998 Jan-Feb;4(1):73-82.
Semen parameters, including WHO and strict criteria morphology, in a fertile and subfertile population: an effort towards standardization of in-vivo thresholds. Hum Reprod 2001; 16(6):1165-1171.
Sperm morphology assessment— historical perspectives and current opinions. J Androl 2001 Mar-Apr;22(2):192-205.
Morphological differentiation of human spermatozoa with Testsimplets slides. Andrologia 1977 Apr-Jun;9(2):191-192.
Comparative study of sperm morphology with three different staining procedures. Andrologia 1979 Jul-Aug;11(4):255-258.
Scoring human sperm morphology using Testsimplets and Diff-Quik slides. Fertil Steril 2013 Apr;99(5):1227-1232.
Comparison of the various techniques of identifying human spermatozoa morphology. Acta Eur Fertil 1984 Nov-Dec;15(6):437-440.
Failure of fertilization in in vitro fertilization: the occult male factor. J In Vitro Fert Embryo Transf 1988 Aug;5(4):181-187.
Treatment of sperm-injected human oocytes with Ca2+ ionophore supports the development of Ca2+ oscillations. Biol Reprod 1994 Sep;51(3):385-391.
A, Moghdam A. Effect of human sperm chromatin anomalies on fertilization outcome post-ICSI. Andrologia 2003 Aug;35(4):238-243.
The relationship between sperm chromosomal abnormalities and sperm morphology in humans. Mut Res 1988 Mar-Apr;207(3-4):159-164.
Cytogenetics of human spermatozoa: correlations with sperm morphology and age of fertile men. Fertil Steril 1992 Nov;58(5):1071-1072.
Comparison of sibling oocyte outcomes after intracytoplasmic sperm injection and in vitro fertilization in severe teratozoospermic patients in the first cycle. Int J Androl 2003 Feb;26(1):57-62.
Blastocyst formation in in vitro fertilization versus intracytoplasmic sperm injection cycles: influence of the fertilization procedure. Fertil Steril 2005 May;83(5):1397-1403.
Does severe teratozoospermia affect blastocyst formation, live birth rate, and other clinical outcome parameters in ICSI cycles? Fertil Steril 2010 Mar 1;93(4):1097-1103.
The influence of sperm morphology on preimplantation genetic diagnosis cycles outcome. Fertil Steril 2008 Jun;89(6): 1665.
Increased chromosome X, Y, and 18 nondisjunction in sperm from infertile patients that were identified as normal by strict morphology: implication of intracytoplasmic sperm injection. Fertil Steril 2001 Nov;76(5):879-883.
Sperm selection for ICSI: shape properties do not predict the absence or presence of numerical chromosomal aberrations. Hum Reprod 2004 Sep; 19(9):2052-2059.
Assisted reproductive technologies and the risk of birth defects— a systematic review. Hum Reprod 2005 Feb;20(2):328-338.
In vitro fertilization is associated with an increase in major birth defects. Fertil Steril 2005 Nov;84(5):1308-1315.
Birth defects in children conceived by ICSI compared with children conceived by other IVF-methods; a metaanalysis. Int J Epidemiol 2005 Jun;34(3):696-701.
Real-time fine morphology of motile human sperm cell is associated with IVF-ICSI outcome. J Androl 2002 Jan-Feb;23(1):1-8.
The morphological normalcy of the sperm nucleus and pregnancy rate of intracytoplasmic injection with morphologically selected sperm. Hum Reprod 2005 Jan;20(1):185-190.