IVF or ICSI Selection Stratified by Sperm Head Morphology

Area of Science:

• Reproductive Medicine
• Embryology
• Infertility Treatment

Background:

• Teratozoospermia, characterized by abnormal sperm morphology, is a significant cause of male infertility.
• Sperm head abnormalities, including shape and acrosome defects, can impact fertilization potential.
• Assisted reproductive technologies (ART) like in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI) are options for infertile couples.

Purpose of the Study:

• To evaluate the comparative effectiveness of IVF and ICSI in infertile men with teratozoospermia, specifically focusing on sperm head abnormalities.
• To determine which ART method is more suitable based on the type and severity of sperm head malformations.

Main Methods:

• A retrospective analysis of 856 infertile couples with teratozoospermia.
• Patients were categorized into four groups based on sperm head acrosome and shape malformation rates (<95% or >97%).
• Key outcomes including fertilization, cleavage, blastocyst development, pregnancy, and live birth rates were compared between IVF and ICSI.

Main Results:

• IVF demonstrated higher fertilization and blastocyst formation rates in the head shape malformation <95% group.
• IVF also showed significantly higher fertilization rates in the head acrosome malformation <95% subgroup.
• ICSI resulted in a greater proportion of high-quality blastocysts in the head acrosome malformation >97% subgroup.
• No significant differences in pregnancy or live birth rates were observed between IVF and ICSI across all subgroups.

Conclusions:

• IVF is recommended for sperm head abnormality rates below 95% to optimize fertilization efficiency.
• ICSI is suggested for acrosome malformations exceeding 97% to enhance the yield of high-quality embryos.
• These findings provide evidence-based recommendations for selecting the most appropriate ART strategy for individual patients with teratozoospermia.