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Impact of Abnormal Sperm Morphology on Live Birth Rates Following Intrauterine Insemination
Abstract
Purpose We evaluated the live birth rate and the prevalence of congenital anomalies in couples undergoing intrauterine insemination with abnormal sperm morphology (less than 4% normal forms). Materials and methods We retrospectively reviewed intrauterine insemination outcomes from January 2012 to March 2015. Patients who were found to have an ultrasound confirmed clinical pregnancy were contacted to determine the live birth rate and the prevalence of congenital abnormalities. We used chi-square analysis to assess categorical variables and the Student t-test to assess continuous variables. Logistic regression was done to assess the odds of achieving pregnancy and the risk of spontaneous abortion while assessing female age, the total motile count and sperm morphology. Results In 984 intrauterine insemination procedures performed in a total of 501 couples we found no difference in the ultrasound clinical pregnancy rate in couples with sperm morphology less than 4% vs 4% or greater (12.3% vs 13.6%, p=0.59). We collected live birth and birth abnormality data on 95 of the 130 couples with ultrasound confirmed clinical pregnancy for a 73% response rate. We found no difference in the live birth rate or the spontaneous abortion rate after an ultrasound confirmed clinical pregnancy in couples with abnormal sperm morphology (less than 4% normal forms). There was also no increased risk of birth abnormalities for patients with abnormal sperm morphology. Conclusions Abnormal sperm morpholo…
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Patel et al. found no impact of abnormal sperm morphology on pregnancy or live birth rate after IUI.
“Another study by Patel et al. also found no impact of abnormal sperm morphology on pregnancy or live birth rate after IUI (89).”
From Isolated teratozoospermia: revisiting its relevance in male infertility: a narrative review (2024) · cites this paper as [89]
Most recent studies of smaller series confirmed that sperm morphology had no impact on pregnancy rates after IUI.
“Most recent studies, of smaller series, confirmed these results [76, 77, 78, 79, 80, 81, 82, 83]”
From Recommendations for Human Sperm Morphology Assessment in 2025: An Expert Review From the French BLEFCO Group (2026) · cites this paper as [82]
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Candela, L., Boeri, L., Capogrosso, P., Cazzaniga, W., Pozzi, E., Belladelli, F., Baudo, A., Ravizzoli, A., Ventimiglia, E., Viganò, P., et al. (2021) · PLOS ONE · doi:10.1371/journal.pone.0251608 · Cited by 35
Isolated teratozoospermia: revisiting its relevance in male infertility: a narrative review
Atmoko, W., Savira, M., Shah, R., Chung, E., & Agarwal, A. (2024) · Translational Andrology and Urology · doi:10.21037/tau-23-397 · Cited by 23
“There is no clear evidence whether severe or moderate teratozoospermia compromises chances of natural pregnancy, or whether it is a contra-indication for IUI or IVF.”
InfluentialGatimel, 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
Metadata
- Authors
- Patel, P., Carrasquillo, R., Madhusoodanan, V., Dadoun, S., Patel, A., Smith, N., Collazo, I., Kohn, T., & Ramasamy, R.
- Affiliations
- University of Miami (US)
- Beth Israel Deaconess Medical Center (US)
- South Florida Institute for Reproductive Medicine, Jupiter, Florida
- Johns Hopkins University (US)
- ORCID
- Venue
- Journal of Urology
- Published
- 2019-10
- Volume
- 202
- Issue
- 4
- Pages
- 801-805
- ISSN
- 0022-5347 (ISSN-L)
- 1527-3792
- OpenAlex
- W2941698634
- Cited by
- 18
- References
- 0
- Citations by year
- 2026: 1 · 2025: 2 · 2024: 6 · 2023: 1 · 2022: 1 · 2021: 2 · 2020: 3 · 2019: 2
- FWCI
- 1.91
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The Journal of Urology (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 › Pediatrics, Perinatology and Child Health › Assisted Reproductive Technology and Twin Pregnancy
- Keywords
- abnormal sperm morphology, intrauterine insemination, live birth rate, clinical pregnancy rate, congenital malformations, miscarriage, male infertility, sperm motility
- MeSH terms
- Congenital Abnormalities, Teratozoospermia, Adult, Birth Rate, Female, Fertilization in Vitro, Follow-Up Studies, Humans, Male, Pregnancy, Pregnancy Outcome, Retrospective Studies, Sperm Count, Sperm Motility, Spermatozoa, Prevalence, Treatment Outcome, Pregnancy Rate
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