Role of Abnormal Sperm Morphology in Predicting Pregnancy Outcomes

Abstract

The evaluation of strict morphology for predicting successful pregnancy has been controversial, nevertheless remains an essential component of semen analysis. Patients with teratozoospermia (abnormal strict morphology) have traditionally been counseled to undergo assisted reproduction. However, recent studies suggest that patients with abnormal sperm morphology alone should not be precluded from attempting natural conception before undergoing assisted reproduction. The goal of this review is to provide an update on the evaluation of sperm morphology for prognosis in assisted reproductive techniques such as intrauterine insemination and in vitro fertilization with or without intracytoplasmic sperm injection. Additionally, we propose a logical approach to the evaluation of a patient with teratozoospermia seeking fertility treatment.

Oxidation-reduction potential as a new marker for oxidative stress: Correlation to male infertility

“…ORP's relationship to sperm morphology is inconsistent. This adds to the controversy of whether to use sperm morphology as an indicator of sperm function [ 69 70 71 ]. The aforementioned clinical studies found weak evidence in supporting ORP to predict teratozoospermia [ 55 56 ].…”

Effects of the normal sperm morphology rate on the clinical and neonatal outcomes of conventional IVF cycles

“…The association between NSMR and the choice of infertility treatments (intrauterine insemination (IUI), IVF or ICSI) has remained controversial. Shabtaie, Gerkowicz, Kohn, and Ramasamy (2016) suggested that IUI should be recommended for males with abnormal sperm morphology when other sperm parameters were normal in the absence of female infertility factors. A meta‐analysis also showed that sperm morphology had no effect on pregnancy success rates in a total of 41,018 IUI cycles (Kohn, Kohn, & Ramasamy, 2018).…”

“…ICSI is more invasive for oocytes than conventional IVF (c‐IVF), and c‐IVF may be the better choice for patients who require treatment with IVF/ICSI. The current literature has mainly focused on the effects of NSMR on pregnancy outcomes (Keegan et al, 2007; Shabtaie et al, 2016; Sun et al, 2012). In our retrospective study, we analysed the effects of NSMR (<4% versus ≥4%) on the clinical and neonatal outcomes of c‐IVF.…”

Calidad seminal e inseminación intrauterina: estudio retrospectivo

“…Resultados similares han sido obtenidos por otros autores y sugieren que ese parámetro por sí solo no es confiable, debido a la subjetividad inherente y la creciente proporción de hombres diagnosticados erróneamente con morfología anormal, causando una pérdida de su valor predictivo. [23][24][25][26] Así, Shabtaie y col., 23 recomienda realizar la inseminación a pesar de la morfología anormal considerada por el manual actual de la OMS (< 4% de formas normales), 9 siempre y cuando las muestras seminales presenten movilidad y concentración espermáticas normales. 23 En contraste, en un estudio prospectivo realizado por Butcher y col., 27 se encontró en 1243 ciclos de IIU que altos niveles de morfología normal (!…”

“…[23][24][25][26] Así, Shabtaie y col., 23 recomienda realizar la inseminación a pesar de la morfología anormal considerada por el manual actual de la OMS (< 4% de formas normales), 9 siempre y cuando las muestras seminales presenten movilidad y concentración espermáticas normales. 23 En contraste, en un estudio prospectivo realizado por Butcher y col., 27 se encontró en 1243 ciclos de IIU que altos niveles de morfología normal (! 18% de formas normales), son un indicador clínico positivo y podría incrementar la probabilidad de embarazo.…”