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Volume 23, Issue 4 (July 2021) 23, 421–428; 10.4103/aja.aja_91_20

Influence of sperm morphology on pregnancy outcome and offspring in in vitro fertilization and intracytoplasmic sperm injection: a matched case-control study

Wen-Jun Zhou1, Chuan Huang2,3, Su-Hua Jiang1, Xi-Ren Ji1, Fei Gong1,2,3, Li-Qing Fan1,2,3, Wen-Bing Zhu1,2,3

1 Institute of Reproductive and Stem Cell Engineering, Basic Medicine College, Central South University, Changsha 410008, China
2 Reproductive and Genetic Hospital of CITIC-Xiangya, Changsha 410008, China
3 Clinical Research Center for Reproduction and Genetics in Hunan Province, Changsha 410008, China

Correspondence: Dr. WB Zhu (zhuwenbing0971@sina.com)

Date of Submission 03-Jun-2020 Date of Acceptance 24-Nov-2020 Date of Web Publication 29-Jan-2021


Sperm morphology was once believed as one of the most predictive indicators of pregnancy outcome in assisted reproductive technology (ART). However, the impact of teratozoospermia on in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI) outcomes and its offspring remains inconclusive. In order to evaluate the influence of teratozoospermia on pregnancy outcome and newborn status after IVF and ICSI, a retrospective study was conducted. This was a matched case-control study that included 2202 IVF cycles and 2574 ICSI cycles and was conducted at the Reproductive and Genetic Hospital of CITIC-Xiangya in Changsha, China, from June 2013 to June 2018. Patients were divided into two groups based on sperm morphology: teratozoospermia and normal sperm group. The pregnancy outcome and newborn outcome were analyzed. The results indicated that couples with teratozoospermia had a significantly lower optimal embryo rate compared to those with normal sperm morphology in IVF (P = 0.007), while there were no statistically significant differences between the two groups in terms of the fertilization rate, cleavage rate, implantation rate, and pregnancy rate (all P > 0.05). Additionally, teratozoospermia was associated with lower infant birth weight in multiple births after IVF. With regard to ICSI, there was no significant difference in both pregnancy outcome and newborn outcome between the teratozoospermia and normal groups (both P > 0.05). Furthermore, no increase in the risk of birth defects occurred in the teratozoospermia group after IVF/ICSI. Consequently, we believe that teratozoospermia has limited predictive value for pregnancy outcomes in IVF/ICSI, and has little impact on the resulting offspring if multiple pregnancy is avoided.

Keywords: in vitro fertilization; intracytoplasmic sperm injection; newborn outcome; pregnancy outcome; teratozoospermia

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