Effect of normal sperm morphology rate (NSMR) on clinical outcomes and fertilization methods selection in the ultra-short-term GnRH-a protocol

Abstract

Purpose: To investigate whether intracytoplasmic sperm injection (ICSI) can improve the clinical outcomes of the male patients with teratozoospermia in the ultra-short term GnRH-a protocol.

Methods: Based on different normal sperm morphology rate (NSMR), the patients were divided into three groups as follows: NSMR = 0% group, 1% ≤NSMR <4% group and NSMR ≥4% group. Each group was compared with two fertilization type of in-vitro fertilization (IVF) and ICSI separately. Main outcomes compared were normal fertilization, high-quality embryo, transferrable embryo, implantation, pregnancy and abortion rate.

Results: We observed that the total clinical pregnancy rate in single cleavage-stage embryo transfer (SET) group was significantly lower compared with double cleavage-stage embryo transfer (DET) group (23.87% versus 40.08%; p < 0.001). There was no significant difference in the aspects of female age, endometrial thickness, infertility duration and the number of retrieved oocytes among three groups (p > 0.05). The normal fertilization, high-quality embryo, transferrable embryo, implantation, pregnancy and abortion rate of IVF and ICSI showed no significant difference among three groups (p > 0.05).

Conclusion: ICSI cannot improve clinical outcomes of the patients with teratozoospermia in the ultra-short term GnRH-a protocol.

Chinese abstract

目的：研究男性畸形精子症患者中正常精子形态率(NSMR)是否对GnRH-a超短方案临床结局及受精方法的选择有影响。

方法：根据不同的NSMR进行分组：NSMR=0组；1% ≦NSMR＜4%组及NSMR≥4%组。每组又根据体外受精技术分为两组，IVF组及ICSI组。从正常受精率、高质量胚胎率、可移植胚胎率及移植率、妊娠率、流产率等几个方面进行比较。

结果：单胚胎移植(SET)的妊娠率低于双胚胎移植(DET)(23.87% 对 40.08%; p＜0.001)。三组的女性年龄、内膜厚度、不孕持续时间及取卵数的差异无统计学意义(p＞0.05)。三组间的正常受精率、高质量胚胎率、可移植胚胎率及移植率、妊娠率、流产率的差异无统计学意义(p＞0.05)。

结论：在GnRH-a超短方案中，ICSI并不能改善男性畸形精子症患者的临床结局。

• Pregnancy
• sperm morphology
• ultra-short term GnRH-a protocol

Declaration of interest

The authors report no conflicts of interest.