Evaluation of the effect of the absence of sperm with rapid and linear progressive motility on subsequent pregnancy rates following intrauterine insemination or in vitro fertilization.

The objective of this study was to investigate the association of rapid and linear progressive motility in seminal and Percoll-separated sperm with the outcome of intrauterine insemination (IUI) and in vitro fertilization (IVF) cycles. Motility was graded using the qualitative system proposed by the World Health Organization: grade A, rapid and linear, grade B, slow or nonlinear; grade C, non-progressive; or grade D, nonmotile. Absence of rapid and linear motility was defined as grade A sperm absent. Nine-hundred-fifty IVF and 1,448 IUI cycles were analyzed. In 7.9% (75) of the IVF cycles, grade A sperm were absent in the semen. Although the mean fertilization rate was lower in the absence of grade A sperm in the semen (44.5% vs. 63.4%, P < 0.05), the pregnancy rates were similar irrespective of their presence or absence (18.7% vs. 17.8%). In the cycles in which grade A sperm were absent following Percoll separation (26/950; 2.7%), the fertilization rate (29% vs. 62.8%) and the clinical pregnancy rate/retrieval were significantly lower (3.8% vs. 18.3%, P < 0.05). In 26.4% (382) of the IUI cycles, grade A sperm were absent in the semen and conception occurred in 30 (7.9%), compared to a pregnancy rate of 10.4% in the group with grade A sperm present in the semen. Following Percoll separation, only a 2.5% (2/80) pregnancy rate was observed in the group with no grade A sperm, compared to 10.2% in the group with grade A sperm (P < 0.05). The absence of rapid and linear motile sperm in the Percoll-separated sperm significantly reduced fertilization rates in vitro and pregnancy rates in both IUI and IVF cycles. The use of the total number of grade A sperm was also effective in predicting reduced fertilization in IVF and reduced pregnancy rates in IUI, but no better than the use of the mere presence/absence of grade A sperm. In a clinical situation, the simpler test is preferable. This type of evaluation is available to all centers as opposed to the more expensive computer-assisted semen analysis.

[1]  D. Lurie,et al.  Intrauterine insemination for cervical and male factor without superovulation. , 1995, Archives of andrology.

[2]  J. Check,et al.  Chymotrypsin‐Galactose Treatment of Sperm With Antisperm Antibodies Results in Improved Pregnancy Rates Following in Vitro Fertilization , 1995, American journal of reproductive immunology.

[3]  J. Check,et al.  The use of chymotrypsin/galactose to treat spermatozoa bound with anti-sperm antibodies prior to intra-uterine insemination. , 1994, Human reproduction.

[4]  D. Lurie,et al.  Pregnancy: Adverse effect of a homogeneous hyperechogenic endometrial sonographic pattern, despite adequate endometrial thickness on pregnancy rates following in-vitro fertilization , 1993 .

[5]  Zsolt Peter Nagy,et al.  High fertilization and implantation rates after intracytoplasmic sperm injection , 1993 .

[6]  J. Check,et al.  Influence of endometrial thickness and echo patterns on pregnancy rates during in vitro fertilization. , 1991, Fertility and sterility.

[7]  G. Clarke,et al.  Relationship between sperm motility assessed with the Hamilton-Thorn motility analyzer and fertilization rates in vitro. , 1991, Journal of andrology.

[8]  J. Yovich,et al.  Influence of pentoxifylline in severe male factor infertility. , 1990, Fertility and sterility.

[9]  J E Garcia,et al.  Follicular phase gonadotropin-releasing hormone agonist and human gonadotropins: a better alternative for ovulation induction in in vitro fertilization. , 1990, Fertility and sterility.

[10]  S. Y. Chan,et al.  Evaluation of computerized analysis of sperm movement characteristics and differential sperm tail swelling patterns in predicting human sperm in vitro fertilizing capacity. , 1989, Journal of andrology.

[11]  D. Meldrum,et al.  Routine pituitary suppression with leuprolide before ovarian stimulation for oocyte retrieval. , 1989, Fertility and sterility.

[12]  F. Comhaire,et al.  Validation of a single-step procedure for the objective assessment of sperm motility characteristics. , 1988, International journal of andrology.

[13]  Z. Rosenwaks,et al.  Corrective measures and pregnancy outcome in in vitro fertilization in patients with severe sperm morphology abnormalities. , 1988, Fertility and sterility.

[14]  D. Green,et al.  SPERM THRUSTS AND THE PROBLEM OF PENETRATION , 1988, Biological reviews of the Cambridge Philosophical Society.

[15]  F. Comhaire,et al.  Reassessment of the accuracy of traditional sperm characteristics and adenosine triphosphate (ATP) in estimating the fertilizing potential of human semen in vivo. , 1987, International journal of andrology.

[16]  R. Frydman,et al.  Sperm factors related to failure of human in-vitro fertilization. , 1986, Journal of reproduction and fertility.

[17]  W. Holt,et al.  Computer-assisted measurement of sperm swimming speed in human semen: correlation of results with in vitro fertilization assays. , 1985, Fertility and sterility.

[18]  R. Bronson,et al.  Sperm antibodies: their role in infertility. , 1984, Fertility and sterility.

[19]  S. Yen,et al.  Hormonal dynamics at midcycle: a reevaluation. , 1983, The Journal of clinical endocrinology and metabolism.

[20]  J. Garcia,et al.  Prediction of the time of ovulation. , 1981, Fertility and sterility.

[21]  J. Check,et al.  Correlation of computerized semen analysis with successful fertilization of oocytes in an in vitro fertilization program. , 1990, Archives of andrology.

[22]  S. Oehninger,et al.  Predictive value of abnormal sperm morphology in in vitro fertilization. , 1988, Fertility and sterility.

[23]  J. Baltz,et al.  The Biophysics of Sperm Penetration of the Cumulus and Zona Pellucida , 1987 .

[24]  D. Mortimer,et al.  Human sperm motility after migration into, and incubation in, synthetic media , 1984 .