Does sperm morphology affect the outcome of intrauterine insemination in patients with normal sperm concentration and motility?
Open accessAbstract
The aim of this study was to assess the correlation of sperm morphology with the intrauterine insemination (IUI) outcome in patients with normal sperm concentration and motility. About 412 couples who underwent 908 IUI cycles were involved in the present study. A total of 110 clinical pregnancies were achieved with a pregnancy rate of 12.11% per cycle. The pregnancy rates per cycle were 7.60%, 12.67%, 13.62% and 13.13% in patients with <5%, 5-9%, 10-14% and >14% normal forms, respectively. The lowest pregnancy rate (7.60%) was obtained in the group with normal forms below 5%. However, this rate was not significantly different from other subgroups. Moreover, no pregnancies occurred in women >35 years old with normal sperm forms below 5%, in comparison with that in other subgroups of the same age. For women younger than 35 years old, no significant difference in pregnancy rate was observed in terms of different level of morphologically normal sperm. Our results show that for patients with normal sperm concentration and motility, IUI is recommended for first-line treatment when the woman is younger than 35 years, or morphologically normal sperm is ≥ 5%. IVF/ICSI should be performed when the normal forms are <5% and female age is > 35 years.
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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 [76]
The Discussion (page unavailable) reports no statistically significant difference in pregnancy rates across sperm-morphology groups, supporting the main point for couples with normal sperm concentration and motility. But the paper also reports no pregnancies among women over 35 when normal sperm forms were below 5%, so its findings do not support an unqualified claim that morphology had no impact. (LLM, conf=0.85)
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Impact of isolated teratozoospermia on the outcome of intrauterine insemination
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- Authors
- Sun, Y., Li, B., Fan, L. Q., Zhu, W. B., Chen, X. J., Feng, J. H., Yang, C. L., & Zhang, Y. H.
- Affiliations
- Third Affiliated Hospital of Guangzhou Medical University (CN)
- Central South University (CN)
- Corresponding author
- Li, B.
- Venue
- Andrologia
- Publisher
- Hindawi Limited
- Published
- 2012-02-16
- Volume
- 44
- Issue
- 5
- Pages
- 299-304
- ISSN
- 0303-4569 (ISSN-L)
- OpenAlex
- W1983622650
- Cited by
- 28
- References
- 4
- Citations by year
- 2026: 1 · 2025: 1 · 2024: 4 · 2021: 4 · 2020: 4 · 2019: 1 · 2018: 1 · 2017: 3 · 2016: 2 · 2015: 2 · 2014: 2 · 2013: 2 · 2012: 1
- FWCI
- 2.62
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Andrologia (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Guangzhou Municipal Health and Family Planning Commission
- 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, pregnancy rate, sperm motility, maternal age, IVF/ICSI
- MeSH terms
- Adult, Female, Humans, Insemination, Insemination, Artificial, Homologous, Male, Maternal Age, Pregnancy, Retrospective Studies, Sperm Count, Sperm Motility, Spermatozoa, Treatment Outcome
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