Real‐Time Fine Morphology of Motile Human Sperm Cells is Associated With IVF‐ICSI Outcome

Abstract

The aim of the present prospective study was to determine whether subtle sperm morphological characteristics affect the outcome of intracytoplasmic sperm injection (ICSI), and if so, to identify those that are relevant. For this purpose, we developed a new method, the motile sperm organelle morphology examination (MSOME). The examination is performed in real time using an inverted light microscope equipped with high-power Nomarski optics enhanced by digital imaging to achieve a magnification up to 6300x. MSOME was applied to the leftover sperm fraction selected for microinjection in 100 random couples referred for ICSI treatment at 3 major in vitro fertilization centers. We found that the morphological normalcy of the entire sperm cell, according to MSOME criteria, was positively associated with ICSI fertilization rate (area under the receiver operating characteristics [ROC] curve, 88%) but not with pregnancy outcome. The morphological normalcy of the sperm nucleus, defined by MSOME, was significantly and positively associated with both fertilization rate and pregnancy outcome (areas under the ROC curve, 72% and 74%, respectively). These findings indicate that ICSI-associated pregnancy rate may be affected by subtle morphological malformations of the sperm nucleus, which may remain undetected by the embryologist during the routine selection procedure.

CASA derived human sperm abnormalities: correlation with chromatin packing and DNA fragmentation

“…Traditionally, semen parameters like sperm count, motility and morphology were considered for assessment of male factor. Of these, sperm morphology is much emphasized recently and is proven to be one of the important predictors in determining the fertilizing capacity of sperm both in vivo and in vitro conditions [23][24][25]. Several clinical studies have demonstrated a clear association between sperm head morphology and improvement in IVF success rate [4,26,27].…”

Guidance and Self‐Sorting of Active Swimmers: 3D Periodic Arrays Increase Persistence Length of Human Sperm Selecting for the Fittest

“…After drying, glass slides were imaged using a NanoZoomer 2.0 RS with 40× magnification (Hamamatsu). Based on the generated images, sperm were classified into different morphologies as described previously by Bartoov et al75 …”

The predictive value of high-magnification sperm morphology examination on ICSI outcomes in the presence of oocyte dysmorphisms

“…Several publications reported that the IMSI procedure is positively associated with pregnancy rates in couples with previous and repeated implantation failures [6,7,9,34] and in patients with an elevated degree of DNA fragmented spermatozoa [27,48]. Moreover, a recently published meta-analysis showed that the IMSI procedure is associated with improved embryo quality, implantation, pregnancy and miscarriage rates [40].…”