Influence of strict sperm morphology on the results of classic in vitro fertilization

Ghirelli-Filho, Milton; Mizrahi, Françoise Elia; Pompeo, Antônio Carlos Lima; Glina, Sidney

doi:10.1590/s1677-55382012000400012

Cited by 16 publications

(18 citation statements)

References 22 publications

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“…Among the many factors that influence the outcomes of IVF, semen parameters have traditionally been used as an indicator for oocyte fertilization and attainment of pregnancy in addition to the quality of the oocyte 20. In 1986, Kruger et al 2.…”

Section: Discussionmentioning

confidence: 99%

Men with a complete absence of normal sperm morphology exhibit high rates of success without assisted reproduction

et al. 2017

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In couples with infertility, abnormal strict morphology of 0% normal forms (NF) is a criterion to proceed rapidly to in vitro fertilization (IVF). Since no data currently exist, we investigated the outcomes for men with 0% NF to determine reproductive success without the use of assisted reproductive technologies (ART). A cohort of 24 men with 0% NF were identified (2010–2013) with 27 randomly selected men with ≥4% NF as controls. Patient charts were reviewed with men contacted and administered an Institutional Review Board (IRB)-approved telephone questionnaire to ascertain outcomes. After a median follow-up time of 2.5 years, 29.2% of men with 0% NF did not require ART for their first pregnancy (controls = 55.6%, P ≤ 0.05). When all pregnancies were analyzed together, men with 0% NF achieved twenty pregnancies of which 75% did not require IVF (controls = thirty pregnancies; 76.7% did not require IVF). The average age of men and female partners was similar between men with 0% NF and ≥4% NF. All men had normal follicle-stimulating hormone (FSH), testosterone, prolactin, sex hormone-binding globulin (SHBG), and estradiol. Although, global semen parameters were worse in men with 0% NF, when a first pregnancy was a natural conception (NC), 100% of men with 0% NF (n = 7/7) and 37.5% of controls (n = 3/8) went on to have a subsequent pregnancy via NC. Men with 0% NF conceived without IVF in 29.2% of cases compared to 55.6% of controls. Strict morphology should not be used to predict fertilization, pregnancy, or live birth potential. In men with 0% NF, alternative modalities should be considered before immediate IVF.

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Section: Discussionmentioning

confidence: 99%

Men with a complete absence of normal sperm morphology exhibit high rates of success without assisted reproduction

et al. 2017

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“…This of course is not a practical solution for a busy laboratory and especially when the clinical information obtained is of questionable value (Keegan et al, 2007;Hotaling et al, 2011). It is perhaps, therefore, no surprise that few, if any, robust studies have been able to verify those early findings of Kruger (Hotaling et al, 2011;Ghirelli-Filho et al, 2012;van den Hoven et al, 2015). Hotaling et al (2011) performed a meta-analysis on the effects of strict morphology on the outcome of over 3000 IVF and ICSI cycles and could find no similar relationships between strict criteria and IVF outcome, a lack of reproducibility which calls into question, the validity of the entire 'strict' philosophy'.…”

Section: Sperm Morphologymentioning

confidence: 99%

Uncertainty of measurement and clinical value of semen analysis: has standardisation through professional guidelines helped or hindered progress?

Tomlinson

2016

Andrology

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SUMMARYThis article suggests that diagnostic semen analysis has no more clinical value today than it had 25-30 years ago, and both the confusion surrounding its evidence base (in terms of relationship with conception) and the low level of confidence in the clinical setting is attributable to an associated high level of 'uncertainty'. Consideration of the concept of measurement uncertainty is mandatory for medical laboratories applying for the ISO15189 standard. It is evident that the entire semen analysis process is prone to error every step from specimen collection to the reporting of results and serves to compound uncertainty associated with diagnosis or prognosis. Perceived adherence to published guidelines for the assessment of sperm concentration, motility and morphology does not guarantee a reliable and reproducible test result. Moreover, the high level of uncertainty associated with manual sperm motility and morphology can be attributed to subjectivity and lack a traceable standard. This article describes where and why uncertainty exists and suggests that semen analysis will continue to be of limited value until it is more adequately considered and addressed. Although professional guidelines for good practice have provided the foundations for testing procedures for many years, the risk in following rather prescriptive guidance to the letter is that unless they are based on an overwhelmingly firm evidence base, the quality of semen analysis will remain poor and the progress towards the development of more innovative methods for investigating male infertility will be slow.

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“…Introduction of strict sperm morphology criteria [69] was offered as a means to enhance the diagnostic value and predictability of fertilization, however its efficacy in such prediction has been both supported and refuted [70][71][72][73].…”

Section: Fertilization Failurementioning

confidence: 99%

Role of Assisted Reproduction Techniques in the Management of Unexplained Male Infertility

Gangrade

Patel

2015

Unexplained Infertility

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Influence of strict sperm morphology on the results of classic in vitro fertilization

Abstract: ARTICLE INFO ___________________________________________ _

Cited by 16 publications

References 22 publications

Men with a complete absence of normal sperm morphology exhibit high rates of success without assisted reproduction

Men with a complete absence of normal sperm morphology exhibit high rates of success without assisted reproduction

Uncertainty of measurement and clinical value of semen analysis: has standardisation through professional guidelines helped or hindered progress?

Role of Assisted Reproduction Techniques in the Management of Unexplained Male Infertility

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Influence of strict sperm morphology on the results of classic in vitro fertilization

Abstract: ARTICLE INFO _______________________________________________________________ _____________________

Cited by 16 publications

References 22 publications

Men with a complete absence of normal sperm morphology exhibit high rates of success without assisted reproduction

Men with a complete absence of normal sperm morphology exhibit high rates of success without assisted reproduction

Uncertainty of measurement and clinical value of semen analysis: has standardisation through professional guidelines helped or hindered progress?

Role of Assisted Reproduction Techniques in the Management of Unexplained Male Infertility

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Abstract: ARTICLE INFO ___________________________________________ _