Impact of Abnormal Sperm Morphology on Live Birth Rates Following Intrauterine Insemination

Patel, Premal; Carrasquillo, Robert; Madhusoodanan, Vinayak; Dadoun, Simon; Patel, Amir Shahreza; Smith, Nicole K.; Collazo, I.; Kohn, Taylor P.; Ramasamy, Ranjith

doi:10.1097/ju.0000000000000288

Cited by 15 publications

(15 citation statements)

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“…Sperm morphology examined by strict criteria has been reported by many studies to be highly predictive of pregnancy in intrauterine insemination (123), particularly considering the total numbers of motile sperm used in the inseminate (124)(125)(126)(127). But there is a lack of consensus on this point as further studies have not shown this association (128)(129)(130)(131). These are the result of controversies that arise concerning how and when sperm morphology should be assessed, what methodology should be used for examination, and how to interpret the thresholds of normal forms.…”

Section: Intrauterine Inseminationmentioning

confidence: 99%

Sperm morphology and its disorders in the context of infertility

Oehninger

Kruger

2021

F&S Reviews

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This manuscript reviews sperm morphology and its disorders in the context of infertility. A new look into an old challenge is delivered, based on contemporary scientific and clinical evidence. We highlight the functional repercussions of sperm morphology aberrations and dissect the cause and effect of a variety of insults and pathogenic mechanisms focusing on the relationships among sperm shape, function, and compartmental analysis of cellular and subcellular structures. Different types of teratozoospermia are identified as a sequela of aberrant spermiogenesis, and their proven or speculated origins are discussed. In addition to known and suspected genetic causes, oxidative damage is highlighted as a major plausible pathogenic factor. The examination of sperm morphology with the use of strict criteria provides valuable information to guide the clinician to direct therapeutic management. We emphasize that sperm morphology is probably the most relevant parameter of the traditional semen evaluation and can be used as a valid biomarker of functional deficiencies, providing information about chances of conception. The information provided by the examination of sperm morphology as part of a complete semen analysis becomes more and more significant from a clinical point of view for infertility and perhaps men's health. (Fertil Steril Rev Ò 2021;2:75-92. Ó2020 by American Society for Reproductive Medicine.

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Section: Intrauterine Inseminationmentioning

confidence: 99%

Sperm morphology and its disorders in the context of infertility

Oehninger

Kruger

2021

F&S Reviews

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“…Similarly, when men with sperm morphology of <1% vs. ≥1% were compared, no significant difference was found in clinical pregnancy rate (14.0% vs. 13.9%, P=0.97) or risk difference (1.6%, 95% CI: −4.5 to 7.6). Recent data by Patel et al further confirmed these findings, with sperm morphology (4% normal forms threshold) having no significant effect on clinical pregnancy rate (12.3% vs. 13.6%, P=0.59) or live birth rates in 501 couples undergoing 984 IUI cycles (11). Even patients with the most severe forms of isolated teratozoospermia (0% normal forms) have approximately a 30% chance of a natural conception and do not require IVF or ICSI upfront (12).…”

Section: Semen Analysis (Sa) Abnormalitiesmentioning

confidence: 82%

Reasons that should prompt a referral to a reproductive urologist: guidelines for the gynecologist and reproductive endocrinologist

et al. 2019

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Obstetricians and gynecologists, and in particular reproductive endocrinologists (REIs), are typically the gatekeepers and first-line providers for couples initially seeking an infertility evaluation. A timely referral to a reproductive urologist may improve pregnancy outcomes in certain clinical scenarios. This review examines the evidence behind circumstances requiring referral and delivers practice-based recommendations on commonly encountered scenarios in the clinic. Scenarios that should prompt referral to a reproductive urologist include semen analysis (SA) abnormalities (e.g., asthenozoospermia, azoospermia, globozoospermia, leukocytospermia, necrozoospermia, oligospermia), recurrent intrauterine insemination (IUI)/in vitro fertilization (IVF) failure, and idiopathic recurrent pregnancy loss (RPL). Conversely, deferment is appropriate in the cases of isolated teratozoospermia and subclinical varicocele. Men with infertility are also at higher risk for other comorbid conditions and should have at least a baseline evaluation by a primary care physician. Coordination of care between a REI and reproductive urologist is critical in several clinical scenarios and expedient referral can improve reproductive outcomes.

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“…The high miscarriage rate in the mild male infertility group could be related to sperm morphology, but we cannot comment further about the effect of the spermiogram because of the limitations of the retrospective study. On the other hand, a recent study which included 501 couples stated that abnormal sperm morphology did not impact live birth rates [30].…”

Section: Discussionmentioning

confidence: 98%

Does different subfertility etiology affect pregnancy rates in intrauterine insemination cycles?

Turgay¹,

Şükür²,

Özmen³

et al. 2019

Turk J Med Sci

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Background/aim: To investigate the relationship between subfertility etiologies and success rates in controlled ovarian stimulation and intrauterine insemination (COS-IUI) cycles. Materials and methods: The medical records of 218 couples who applied to a university-based fertility center were analyzed retrospectively. Detailed infertility examination data and pregnancy outcomes were compared according to different subfertility etiologies. The study groups with regard to subfertility etiologies were minimal-mild endometriosis, unexplained infertility, and mild male infertility. The primary outcome measure was live birth rate. Results: There were no statistically significant differences between the groups regarding demographics except for total motile sperm count. Live birth rates in the male infertility group were comparable to the endometriosis and unexpected infertility groups (6.6%, 11.9%, and 10.3%, respectively; P = 0.63). Conclusion: The success rate of the mild male subfertility group following COS-IUI cycles for live birth rates was similar to those of the endometriosis and unexplained subfertility groups.

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Impact of Abnormal Sperm Morphology on Live Birth Rates Following Intrauterine Insemination

Cited by 15 publications

References 0 publications

Sperm morphology and its disorders in the context of infertility

Sperm morphology and its disorders in the context of infertility

Reasons that should prompt a referral to a reproductive urologist: guidelines for the gynecologist and reproductive endocrinologist

Does different subfertility etiology affect pregnancy rates in intrauterine insemination cycles?

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