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Does severe teratozoospermia affect blastocyst formation, live birth rate, and other clinical outcome parameters in ICSI cycles?
Fertil Steril 2010; 93(4):1097-103FS

Abstract

OBJECTIVE

To determine if strict morphology correlates with outcome parameters in couples undergoing intracytoplasmic sperm injection (ICSI).

DESIGN

Retrospective review.

SETTING

Academic nonprofit IVF center.

PATIENT(S)

Couples undergoing IVF/ICSI.

INTERVENTION(S)

In vitro fertilization and ICSI.

MAIN OUTCOME MEASURE(S)

Samples were evaluated for total sperm count, motlity, progression, and morphology using Kruger's strict criteria. The ICSI cycle outcome parameters included fertilization, clinical pregnancy, implantation, live birth, and blastulation rates and blastocyst quality.

RESULT(S)

Fertilization rates were high (74%-77%), and clinical pregnancy rates ranged from 60% (subgroup with 0% normal sperm) to 56% (subgroup with >/=7% normal forms). The highest pregnancy and live birth rates were observed in eggs fertilized with sperm from specimens with the most severe teratozoospermia. The blastulation rate was similar among subgroups. The percentage of high-quality blastocysts was significantly greater in the severely teratozoospermic patients compared with patients with >/=5% normal sperm (37% vs. 28%). This is likely because in the lower morphology subgroups, female factors are less prevalent and the primary infertility problem is male factor.

CONCLUSION(S)

These data suggest that we reconsider the diagnostic value of strict morphology in assisted reproductive technology cycles involving ICSI. Sperm morphology assessed by Kruger's strict criteria had little prognostic value in ICSI cycle outcomes. Sperm morphology did not appear to influence blastocyst development or blastocyst morphology. Microscopic selection of sperm with "normal" morphology during the ICSI procedure allowed excellent outcomes even in samples with severe teratozoospermia.

Authors+Show Affiliations

Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, Ohio, USA.

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

19200957

Citation

French, Dan B., et al. "Does Severe Teratozoospermia Affect Blastocyst Formation, Live Birth Rate, and Other Clinical Outcome Parameters in ICSI Cycles?" Fertility and Sterility, vol. 93, no. 4, 2010, pp. 1097-103.
French DB, Sabanegh ES, Goldfarb J, et al. Does severe teratozoospermia affect blastocyst formation, live birth rate, and other clinical outcome parameters in ICSI cycles? Fertil Steril. 2010;93(4):1097-103.
French, D. B., Sabanegh, E. S., Goldfarb, J., & Desai, N. (2010). Does severe teratozoospermia affect blastocyst formation, live birth rate, and other clinical outcome parameters in ICSI cycles? Fertility and Sterility, 93(4), pp. 1097-103. doi:10.1016/j.fertnstert.2008.10.051.
French DB, et al. Does Severe Teratozoospermia Affect Blastocyst Formation, Live Birth Rate, and Other Clinical Outcome Parameters in ICSI Cycles. Fertil Steril. 2010 Mar 1;93(4):1097-103. PubMed PMID: 19200957.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Does severe teratozoospermia affect blastocyst formation, live birth rate, and other clinical outcome parameters in ICSI cycles? AU - French,Dan B, AU - Sabanegh,Edmund S,Jr AU - Goldfarb,James, AU - Desai,Nina, Y1 - 2009/02/06/ PY - 2008/06/05/received PY - 2008/10/27/revised PY - 2008/10/29/accepted PY - 2009/2/10/entrez PY - 2009/2/10/pubmed PY - 2010/4/2/medline SP - 1097 EP - 103 JF - Fertility and sterility JO - Fertil. Steril. VL - 93 IS - 4 N2 - OBJECTIVE: To determine if strict morphology correlates with outcome parameters in couples undergoing intracytoplasmic sperm injection (ICSI). DESIGN: Retrospective review. SETTING: Academic nonprofit IVF center. PATIENT(S): Couples undergoing IVF/ICSI. INTERVENTION(S): In vitro fertilization and ICSI. MAIN OUTCOME MEASURE(S): Samples were evaluated for total sperm count, motlity, progression, and morphology using Kruger's strict criteria. The ICSI cycle outcome parameters included fertilization, clinical pregnancy, implantation, live birth, and blastulation rates and blastocyst quality. RESULT(S): Fertilization rates were high (74%-77%), and clinical pregnancy rates ranged from 60% (subgroup with 0% normal sperm) to 56% (subgroup with >/=7% normal forms). The highest pregnancy and live birth rates were observed in eggs fertilized with sperm from specimens with the most severe teratozoospermia. The blastulation rate was similar among subgroups. The percentage of high-quality blastocysts was significantly greater in the severely teratozoospermic patients compared with patients with >/=5% normal sperm (37% vs. 28%). This is likely because in the lower morphology subgroups, female factors are less prevalent and the primary infertility problem is male factor. CONCLUSION(S): These data suggest that we reconsider the diagnostic value of strict morphology in assisted reproductive technology cycles involving ICSI. Sperm morphology assessed by Kruger's strict criteria had little prognostic value in ICSI cycle outcomes. Sperm morphology did not appear to influence blastocyst development or blastocyst morphology. Microscopic selection of sperm with "normal" morphology during the ICSI procedure allowed excellent outcomes even in samples with severe teratozoospermia. SN - 1556-5653 UR - https://www.unboundmedicine.com/medline/citation/19200957/Does_severe_teratozoospermia_affect_blastocyst_formation_live_birth_rate_and_other_clinical_outcome_parameters_in_ICSI_cycles L2 - https://linkinghub.elsevier.com/retrieve/pii/S0015-0282(08)04430-0 DB - PRIME DP - Unbound Medicine ER -