Evidence That Sperm with Zero Percent Normal Morphology Using Strict Criteria Is Not a Clinically Important Infertility Factor
Jerome H Check*, Wendy Hourani BS, Donna Summers MA, Michael Sobel DO, Danya Horwath MS
ABSTRACT
Almost 40 years ago sperm with <4% normal morphology using strict criteria was considered such a significant abnormality that the recommendation was to consider the use of donor sperm. Over the years it became clear that low percentage of sperm with normal morphology was not a very good predictor of male subfertility. Nevertheless, there is the possibility that when there is the absence of any sperm with normal morphology (with the exception of 100% globozoospermia), this may be a factor predicting male subfertility. However, just with natural intercourse correcting a female infertility factor 4 of 10 women (40%) delivered a live baby in just 21 cycles (19.0% live delivery per cycle. Through in vitro fertilization embryo transfer with intracytoplasmic sperm injection) (IVF-ET with ICSI) resulted in fifty-two of eighty-four women (61.5%) achieving a live baby in one hundred and six transfers (49.0% per transfer), this is the usual difference in success rates with natural intercourse vs IVF-ET partly related to only one egg released in natural cycles and generally two embryos transferred in IVF-ET cycles (1.92 in this study). Thus, zero% normal morphology should not be the sole reason for choosing IVF with or without ICSI.
