Teratozoospermia and in-vitro fertilization: a randomized prospective study

Area of Science:

• Reproductive Medicine
• Andrology
• In-Vitro Fertilization

Background:

• Sperm morphology assessment is a key factor in evaluating male fertility.
• Strict criteria for sperm morphology are essential for accurate prognostic value in assisted reproductive technologies.
• The impact of isolated teratozoospermia on in-vitro fertilization outcomes requires further investigation.

Purpose of the Study:

• To evaluate the prognostic significance of sperm morphology, assessed by strict criteria, in an in-vitro fertilization (IVF) program.
• To compare IVF outcomes between couples with isolated teratozoospermia and those with normal semen parameters.

Main Methods:

• Prospective randomized study comparing two groups: teratozoospermic (morphology < 9% normal) and control (morphology > 9% normal).
• 50 in-vitro fertilization cycles were performed in each group.
• Patients were matched for age, infertility duration, and IVF indications; key sperm parameters were analyzed.

Main Results:

• Significantly lower fertilization rates (69.2% vs. 79.4%) and pregnancy rates per cycle (12.0% vs. 42%) were observed in the teratozoospermic group.
• Pregnancy rates per transfer (13.9% vs. 42%) and per embryo transferred (6.1% vs. 14.8%) were also significantly reduced in the teratozoospermic group.
• No pregnancies occurred in cases with severe teratozoospermia (morphology < 5% normal).

Conclusions:

• Strict criteria for sperm morphology assessment are valuable predictors of fertilization and pregnancy rates in human in-vitro fertilization.
• Isolated teratozoospermia, particularly severe cases, is associated with poor IVF outcomes.
• Even with normal fertilization rates, moderate teratozoospermia can lead to reduced conception rates.