The impact of sperm morphology on the outcome of intrauterine insemination cycles with gonadotropins in unexplained and male subfertility
Abstract
Objective To determine the impact of sperm morphology on success of intrauterine insemination (IUI) in unexplained and male subfertility. Study design Basal and post-wash normal percentage of sperm with normal morphology was assessed prospectively in 412 couples with 530 IUI cycles who underwent ovarian hyperstimulation with gonadotropins. The primary outcome was live birth per cycle. Receiver operating characteristics (ROC) curves were used to determine the effectiveness of sperm morphology to predict live birth in IUI cycles. Results Normal sperm morphology (%) after preparation was higher in patients with live birth (5.4 ± 4.5 vs 4.3 ± 4.1; respectively, p Conclusion Morphological evaluation is not a reliable parameter alone for predicting pregnancy outcome in unexplained infertility. In male subfertility, post-wash normal sperm morphology percentage higher than 4.5 increases the probability of live birth.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
In the prospective study by Erdem et al., the percentage of normal forms before and after preparation was significantly higher among patients who achieved a birth in the male infertility subgroup only, and not in the group with unexplained infertility.
“In the prospective study by Erdem et al. [86], the percentage of normal forms (before and after preparation) was significantly higher among patients who achieved a birth in the male infertility subgroup only, and not in the group with unexplained infertility.”
From Recommendations for Human Sperm Morphology Assessment in 2025: An Expert Review From the French BLEFCO Group (2026) · cites this paper as [86]
Other smaller studies observed that sperm morphology affected the outcome of IUI.
“Other studies of smaller series also observed that sperm morphology affected the outcome of IUI [86, 87, 88, 89, 90, 91, 92, 93].”
From Recommendations for Human Sperm Morphology Assessment in 2025: An Expert Review From the French BLEFCO Group (2026) · cites this paper as [86]
Publications examining the impact of morphology on spontaneous pregnancy, intrauterine insemination, and in vitro fertilization reach varying conclusions.
“Despite efforts to standardize methodology for grading sperm morphology, publications examining the impact morphology on spontaneous pregnancy, intrauterine insemination, and in vitro fertilization reach varying conclusions (2, 3, 4, 5, 6, 7, 8, 9, 10).”
From Poor reproducibility of percentage of normally shaped sperm using the World Health Organization Fifth Edition strict grading criteria (2022) · cites this paper as [5]
Cites
Dickey, R. P., Pyrzak, R., Lu, P. Y., Taylor, S. N., & Rye, P. H. (1999) · Fertility and Sterility · doi:10.1016/s0015-0282(98)00519-6 · Cited by 163 · see citing works
Matorras, R., Corcóstegui, B., Perez, C., Mandiola, M., Mendoza, R., & Rodríguez-Escudero, F. J. (1995) · Fertility and Sterility · doi:10.1016/s0015-0282(16)57434-2 · Cited by 70 · see citing works
Hauser, R., Yogev, L., Botchan, A., Lessing, J. B., Paz, G., & Yavetz, H. (2001) · Andrologia · doi:10.1046/j.1439-0272.2001.00404.x · Cited by 49 · see citing works
Isolated teratozoospermia and intrauterine insemination
Spiessens, C., Vanderschueren, D., Meuleman, C., & D'Hooghe, T. (2003) · Fertility and Sterility · doi:10.1016/s0015-0282(03)01172-5 · Cited by 43 · see citing works
Impact of isolated teratozoospermia on the outcome of intrauterine insemination
Grigoriou, O., Pantos, K., Makrakis, E., Hassiakos, D., Konidaris, S., & Creatsas, G. (2005) · Fertility and Sterility · doi:10.1016/j.fertnstert.2004.08.027 · Cited by 19 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
Kohn, T. P., Kohn, J. R., & Ramasamy, R. (2018) · Journal of Urology · doi:10.1016/j.juro.2017.11.045 · Cited by 56 · see citing works
Mazaheri Moghaddam, M., Mazaheri Moghaddam, M., Hamzeiy, H., Baghbanzadeh, A., Pashazadeh, F., & Sakhinia, E. (2021) · Journal of Assisted Reproduction and Genetics · doi:10.1007/s10815-020-02008-w · Cited by 25 · see citing works
Baker, K. C., Steiner, A. Z., Hansen, K. R., Barnhart, K. T., Cedars, M. I., Legro, R. S., Diamond, M. P., Krawetz, S. A., Usadi, R., Baker, V. L., et al. (2022) · F&S Reports · doi:10.1016/j.xfre.2022.03.003 · Cited by 14 · see citing works
Luo, Y., Wu, S., Yuan, J., Zhou, H., Zhong, Y., Zhang, M., Li, Q., Xu, X., Sun, X., & Zhu, D. (2021) · Frontiers in Medicine · doi:10.3389/fmed.2021.638560 · Cited by 13 · see citing works
Gatimel, N., Barbotin, A., Mery, L., Beauvillard, D., Bendayan, M., Boursier, A., Boueilh, T., Pereira, B., Chammas, J., Jacquet, J., et al. (2026) · Andrology · doi:10.1111/andr.70134 · Cited by 2 · see citing works
- Authors
- Erdem, M., Erdem, A., Mutlu, M. F., Ozisik, S., Yildiz, S., Guler, I., & Karakaya, C.
- Affiliations
- Gazi University (TR)
- Venue
- European Journal of Obstetrics & Gynecology and Reproductive Biology
- Publisher
- Elsevier BV
- Published
- 2016-02
- Volume
- 197
- Pages
- 120-124
- ISSN
- 0028-2243 (ISSN-L)
- 0301-2115
- OpenAlex
- W2200473979
- Cited by
- 27
- References
- 5
- Citations by year
- 2026: 1 · 2025: 2 · 2024: 3 · 2023: 1 · 2022: 3 · 2021: 6 · 2020: 4 · 2019: 3 · 2018: 1 · 2017: 3
- FWCI
- 1.52
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- European Journal of Obstetrics & Gynecology and Reproductive Biology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Reproductive Medicine › Sperm and Testicular Function
- Health Sciences › Medicine › Reproductive Medicine › Reproductive Health and Technologies
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Reproductive Biology and Fertility
- Keywords
- sperm morphology, intrauterine insemination, male subfertility, unexplained infertility, live birth prediction, gonadotropin stimulation, sperm washing, ovarian hyperstimulation, pregnancy outcomes
- MeSH terms
- Adult, Female, Fertility Agents, Female, Humans, Infertility, Infertility, Male, Insemination, Artificial, Male, Menotropins, Ovulation Induction, Pregnancy, Pregnancy Outcome, Prognosis, Prospective Studies, Recombinant Proteins, ROC Curve, Spermatozoa, Cohort Studies, Treatment Outcome, Pregnancy Rate, Follicle Stimulating Hormone, Human, Live Birth, Young Adult
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
