Predictive value of morphologically normal sperm concentration in the medium for in-vitro fertilization

Area of Science:

• Reproductive Medicine
• Andrology
• In-Vitro Fertilization

Background:

• Conventional sperm parameters have limitations in predicting IVF outcomes.
• Sperm morphology assessment using strict criteria (MEUSC) offers a more precise evaluation.
• The swim-up procedure can improve sperm quality for insemination.

Purpose of the Study:

• To evaluate the predictive value of MEUSC and conventional sperm parameters on IVF and pregnancy outcomes.
• To assess the impact of sperm morphology before and after swim-up selection on IVF success.
• To determine optimal cut-off points for sperm morphology in predicting IVF outcomes.

Main Methods:

• Sperm samples were analyzed for morphology using strict criteria (MEUSC) and conventional parameters.
• Oocytes were inseminated with a standardized number of progressively motile spermatozoa (50,000).
• IVF and pregnancy outcomes were correlated with pre- and post-swim-up sperm morphology percentages and counts.

Main Results:

• Sperm morphology percentages (MEUSC) in both native (≥5%) and post-swim-up (≥8%) samples were the best predictors of IVF outcome.
• Higher percentages of morphologically normal spermatozoa significantly correlated with increased fertilization and pregnancy rates.
• Patients with both parameters above cut-offs showed 70% fertilization and 23% pregnancy rates, versus 7% and 0% for those below.

Conclusions:

• Sperm morphology using strict criteria is a crucial predictor of IVF success.
• MEUSC can aid in patient selection for IVF, identifying males with potential subfertility.
• The swim-up procedure enhances sperm quality, and post-swim-up morphology is a strong prognostic indicator.