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Cited by 16Sperm and Testicular FunctionReproductive Health and TechnologiesReproductive Biology and Fertility

Sperm morphology: What implications on the assisted reproductive outcomes?

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Cito, Gianmartin, Picone, Rita, Fucci, Rossella, Giachini, Claudia, Micelli, Elisabetta, Cocci, Andrea, Falcone, Patrizia, Minervini, Andrea +3 more·2020·Andrology
DOI 10.1111/andr.12883
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Abstract

Objective: To evaluate the impact of sperm morphology (SM) on laboratory and pregnancy outcomes in conventional intracytoplasmic sperm injection (c‐ICSI) cycles, using the egg donation model to minimize female confounding variables. Materials and methods: We retrospectively collected data of oocyte donation cycles from October 2016 to February 2020. Median seminal parameters, total (1‐2‐3PN) fertilization rate (FR), 2PN FR, cleavage rate (CR), implantation rate (IR), pregnancy rate (PR), miscarriage rate (MR), and live birth rate (LBR) were collected. The study population was divided into three groups: Group 1 with SM < 4%, Group 2 with SM between 4% and 6%, and Group 3 with SM > 6%. Results: Of 741 fresh ICSI cycles and 4507 warmed oocytes were included. Male age was 46.0 (31.0‐72.0) years, and recipients’ age was 44.0 (29.0‐54.0) years. Normal SM was 5.0% (1.0%‐15.0%). Male age was negatively correlated with normal SM (P = .002; Rho −0.113). Oocyte survival rate was 83.3% (16.7%‐100.0%). Total FR was 75.0% (11.1%‐100.0%), 2PN FR was 66.7% (11.1%‐100.0%) %, and CR was 100% (0.0%‐100%). Comparing samples with SM > 6% and those with SM < 4%, 2PN FR was significantly higher in the first group (P = .04). No significant associations were found among groups in terms of CR. IR was 27.7%, resulting significantly higher when normal SM was > 6% (P < .01). Clinical PR was 36.0%, MR was 23.9%, and LBR was 25.9%. PR and LBR were significantly higher in samples with normal SM > 6%, compared to other groups (P = .02 and P < .01, respectively). Conclusions: Although c‐ICSI technique allows the embryologist to select the best quality spermatozoa, male factor plays a key role in achieving successful assisted reproductive outcomes. Normal SM has been shown to have implications not only for laboratory outcomes, in terms of fertilization, but also for clinical findings, as regards implantation, pregnancy, and live birth.

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  • Only two studies found an impact of teratozoospermia on pregnancy rates after ICSI, and they were Grade 1.

    “Only two studies found an impact of teratozoospermia on pregnancy rates after ICSI, and they were Grade 1 [102, 103].”

    From Recommendations for Human Sperm Morphology Assessment in 2025: An Expert Review From the French BLEFCO Group (2026) · cites this paper as [102]

    The Discussion reports higher clinical pregnancy rates when normal sperm morphology exceeded 6% in ICSI cycles using donor oocytes, supporting this paper as a study finding an association. Our copy does not establish that only two studies found such an impact or assign this study a Grade 1 rating. (LLM, conf=0.83)

    Experimental — accuracy not yet measured

  • In the second study [102], sperm parameters other than morphology had a major impact.

    “In the second one [102], sperm parameters other than morphology had a major impact.”

    From Recommendations for Human Sperm Morphology Assessment in 2025: An Expert Review From the French BLEFCO Group (2026) · cites this paper as [102]

    The Results report that sperm concentration and total sperm count were positively correlated with fertilization rates. But viability was not associated with improved laboratory outcomes, and none of these parameters was associated with cleavage rate. The paper therefore supports an impact of some parameters other than morphology, not the broad claim that they had a major impact. (LLM, conf=0.84)

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Authors
Cito, G., Picone, R., Fucci, R., Giachini, C., Micelli, E., Cocci, A., Falcone, P., Minervini, A., Carini, M., Natali, A., & Coccia, M. E.
Affiliations
Azienda Ospedaliero-Universitaria Careggi (IT)
Corresponding author
Cito, Gianmartin
ORCID
Venue
Andrology
Publisher
Wiley
Published
2020-08-28
Volume
8
Issue
6
Pages
1867-1874
ISSN
  • 2047-2919 (ISSN-L)
  • 2047-2927
DOI
10.1111/andr.12883
OpenAlex
W3047478322
Cited by
16
References
2
Citations by year
2026: 2 · 2025: 4 · 2024: 2 · 2023: 2 · 2022: 2 · 2021: 4
FWCI
1.76
Type
journal article
Language
en
Open access
Licence
onlinelibrary.wiley.com/termsAndConditions#vor (vor)
Locations
  • Andrology (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, intracytoplasmic sperm injection, oocyte donation, male factor infertility, fertilization rate, implantation rate, pregnancy rate, live birth rate, male age, embryo quality, miscarriage rate, cleavage rate
MeSH terms
Adult, Aged, Female, Fertilization, Fertilization in Vitro, Humans, Male, Middle Aged, Oocytes, Embryo Implantation, Pregnancy, Pregnancy Outcome, Retrospective Studies, Spermatozoa, Oocyte Donation, Pregnancy Rate, Sperm Injections, Intracytoplasmic, Semen Analysis, Young Adult

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