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Cited by 112Sperm and Testicular FunctionReproductive Health and TechnologiesReproductive Biology and Fertility

Isolated teratozoospermia does not affect in vitro fertilization outcome and is not an indication for intracytoplasmic sperm injection

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Keegan, Brian Robert, Barton, Sara, Sanchez, Xavier, Berkeley, Alan S., Krey, Lewis C., Grifo, Jamie·2007·Fertility and Sterility
DOI 10.1016/j.fertnstert.2007.01.057
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Abstract

Objective To reevaluate clinical management of isolated teratozoospermia, in couples initiating IVF. Design Retrospective analysis of fertility indices in 535 cycles. Setting A large, university-based fertility center. Patient(s) Consecutive couples (n = 495) who had a semen analysis using Kruger/Tyberberg strict criteria at our center within 12 months before undergoing their first and/or second IVF cycle in 2002-2004 with >2 million postwash, motile sperm on the day of egg retrieval. Intervention(s) Eggs were fertilized either by conventional IVF or ICSI. Semen analysis and gamete/embryo manipulation was standardized in all cases. Main outcome measure(s) Fertilization, fertilization failure, pregnancy, and live birth rates. Result(s) There was no statistical difference in fertilization, fertilization failure, pregnancy, and live birth rates in the first or second IVF cycle when comparing couples with isolated teratozoospermia (<5% normal morphology) to those with a normal semen analysis. Furthermore, no improvement in these outcomes was noted when ICSI was used to treat these teratozoospermic couples. Conclusion(s) Because isolated teratozoospermia generally does not impact on the major indices of IVF, these patients need not be subjected to the unnecessary cost and potential risks of ICSI. Future studies, however, should focus on different sperm morphologic and biochemical parameters to determine if they are important for clinical management in IVF.

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  • The ability of sperm morphology to predict in vitro reproductive outcomes was first proposed by Kruger et al., who noted an inverse relationship between successful oocyte fertilization and sperm morphology.

    “The ability of sperm morphology to predict in vitro reproductive outcomes was first proposed by Kruger et al.12 who noted an inverse relationship between successful oocyte fertilization and sperm morphology.”

    From Men with a complete absence of normal sperm morphology exhibit high rates of success without assisted reproduction (2017) · cites this paper as [12]

    The paper’s introductory passage (page unavailable) says Kruger et al. published a novel sperm-morphology assessment in 1986 and correlated it with IVF fertilization likelihood. It does not support the stated inverse relationship with normal sperm morphology: the passage says fertilization rates were lower when the percentage of normal sperm was low. The Discussion also reports that this paper’s own study found no difference in fertilization rates by morphology. (LLM, conf=0.87)

    Experimental — accuracy not yet measured

  • IVF is sufficient and there is no need for ICSI just because of isolated teratozoospermia.

    “IVF is sufficient and there is no need for ICSI just because of isolated teratozoospermia (94).”

    From Isolated teratozoospermia: revisiting its relevance in male infertility: a narrative review (2024) · cites this paper as [94]

  • Keegan et al. concluded that in men with isolated teratozoospermia IVF is sufficient and there is no need for ICSI just because of isolated teratozoospermia.

    “and concluded that in men with isolated teratozoospermia IVF is sufficient and there is no need for ICSI just because of isolated teratozoospermia (94).”

    From Isolated teratozoospermia: revisiting its relevance in male infertility: a narrative review (2024) · cites this paper as [94]

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Research works printed but not linked: 31

  1. World Health Organization. WHO laboratory manual for the exami- nation of human semen and semen-cervical mucus interaction. 4th ed. Cambridge: Cambridge University Press, 1999.
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  4. Kruger TF, Acosta AA, Simmons KF, Swanson RJ, Matta JF, Veeck LL, et al. New method of evaluating sperm morphology with predictive value for human in vitro fertilization. Urology 1987;30:248-51.
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  6. World Health Organization. WHO laboratory manual for the exami- nation of human semen and semen-cervical mucus interaction. 2nd ed. Cambridge: Cambridge University Press, 1987.
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  8. Coetzee K, Kruge TF, Lombard CJ. Predictive value of normal sperm morphology: a structured literature review. Hum Reprod Update 1998;4:73-82.
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Cited by

Sorted by citations

Authors
Keegan, B. R., Barton, S., Sanchez, X., Berkeley, A. S., Krey, L. C., & Grifo, J.
Affiliations
New York University (US)
Corresponding author
Keegan, Brian Robert
ORCID
Venue
Fertility and Sterility
Publisher
Elsevier BV
Published
2007-12
Volume
88
Issue
6
Pages
1583-1588
ISSN
0015-0282 (ISSN-L)
DOI
10.1016/j.fertnstert.2007.01.057
OpenAlex
W2052702008
Cited by
112
References
2
Citations by year
2026: 1 · 2025: 2 · 2024: 3 · 2023: 6 · 2022: 5 · 2021: 4 · 2020: 6 · 2019: 7 · 2018: 5 · 2017: 6 · 2016: 8 · 2015: 9 · 2014: 5 · 2013: 7 · 2012: 8
FWCI
8.07
Type
journal article
Language
en
Open access
Licence
Locations
  • Fertility and Sterility (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, in vitro fertilization, intracytoplasmic sperm injection, fertilization rate, fertilization failure, pregnancy rate, live birth rate, semen analysis, male infertility
MeSH terms
Adult, Birth Rate, Female, Fertilization in Vitro, Humans, Infertility, Male, Male, Pregnancy, Retrospective Studies, Spermatozoa, Treatment Outcome, Sperm Injections, Intracytoplasmic, Cell Shape

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