Isolated abnormal strict morphology is not a contraindication for intrauterine insemination

Abstract

SUMMARYThis study sought to investigate whether isolated abnormal strict morphology (<5% normal forms) and very low strict morphology (0-1% normal forms) affects pregnancy rates in intrauterine insemination (IUI). This was a retrospective study performed at an Academic Medical Center/Reproductive Medicine Center. Four hundred and eight couples were included for 856 IUI cycles. 70 IUI cycles were performed in couples with abnormal strict morphology and otherwise normal semen parameters. Outcomes were measured as clinical pregnancy rate per IUI cycle as documented by fetal heart activity on maternal ultrasound. Clinical pregnancy rate did not significantly differ between the group with abnormal strict morphology [11/70 (15.7%)] and the normal morphology group [39/281 (13.9%)]. Additionally, there was no significant difference between the pregnancy rate in the abnormal morphology group compared to that of our overall institutional IUI pregnancy rate [145/856 (16.9%)]. Furthermore, there was no significant difference between pregnancy rate in the very low morphology group [3/14 (21.4%)] compared to those with normal morphology or the overall IUI pregnancy rate. Patients with isolated abnormal strict morphology have clinical pregnancy rates similar to those with normal morphology for IUI. Even in those with very low normal forms, consideration of IUI for assisted reproduction should not be excluded.

Increasing paternal age and ejaculatory abstinence length negatively influence the intracytoplasmic sperm injection outcomes from egg‐sharing donation cycles

“…However, this limitation is alleviated by the lack of strong correlation between teratozoospermia and reduced ICSI outcomes. 60 According to Lockwood et al, 61 teratozoospermia should not be relevant when choosing IVF technique. In fact, even intrauterine inseminations are successful for teratozoospermic patients.…”

Sperm quality and paternal age: effect on blastocyst formation and pregnancy rates

“…Zhu et al [14] suggested that isolated teratozoospermia (<4% of normal forms according to the Kruger’s classification [15]) justifies the use of ICSI versus IVF to improve the fertilization rate. Conversely, according to Lockwood et al [16], teratozoospermia is not a parameter to be taken into account for the choice of ART technique and allows even intra-uterine inseminations. These results confirm those reported by Fan et al [17].…”

Continued existence of significant disparities in the technical practices of sperm morphology assessment and the clinical implications: results of a French questionnaire

“…In a meta-analysis (43), the threshold values showing an impact of sperm morphology on pregnancy rates were 4% in most cases when strict criteria were used, and varied from 8% (44) to 50% (45) when the WHO (1987,1992) criteria were used. Recent publications have failed to demonstrate a statistically significant difference in pregnancy rates in IUI cycles between groups with or without teratozoospermia (9,46).…”