Role of sperm morphological parameters in the selection of fertilization methods

Papel de los parámetros morfológicos del esperma en la selección de los métodos de fecundación

To investigate the role of in-vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI) in cases with isolated teratozoospermia, and to provide reference for infertile patients to choose a reasonable insemination program. From January 2018 to December 2022, 433 couples received assisted reproductive assistance in the Department of Reproductive Medicine of our hospital. Among them, 81 patients presented isolated teratozoospermia (other sperm parameters were normal). These underwent IVF/ICSI, and differences in embryological data were compared between groups. 60 patients with moderate teratozoospermia went IVF, 11 needed rescue ICSI (R-ICSI, 18.33%), and 49 developed up to the blastocyst stage. 14 patients with severe teratozoospermia went IVF, 2 needed R-ICSI (14.29%), and 12 developed up to the blastocyst stage. There were no statistically significant differences in the proportion of R-ICSI between the two groups. Embryological outcomes were not significantly different between groups. The present results suggest that patients with moderate and severe teratozoospermia can be effectively treated with IVF, being R-ICSI performed when necessary.

Resumen

Investigar el papel de la fertilización in vitro (FIV) o la inyección intracitoplasmática de espermatozoides (ICSI) en casos con teratozoospermia aislada, y proporcionar una referencia para que los pacientes infértiles elijan un programa de inseminación razonable. Desde enero de 2018 hasta diciembre de 2022, 433 parejas recibieron asistencia reproductiva asistida en el Departamento de Medicina Reproductiva de nuestro hospital. Entre ellas, 81 pacientes presentaron teratozoospermia aislada (otros parámetros espermáticos fueron normales). Estos fueron sometidos a FIV/ICSI, y se compararon las diferencias en los datos embriológicos entre los grupos. 60 pacientes con teratozoospermia moderada se sometieron a FIV, 11 necesitaron ICSI de rescate (R-ICSI, 18.33%), y 49 evolucionaron hasta el estadio de blastocisto. 14 pacientes con teratozoospermia grave se sometieron a FIV, 2 necesitaron ICSI-R (14.29%) y 12 alcanzaron la fase de blastocisto. No hubo diferencias estadísticamente significativas en la proporción de R-ICSI entre los dos grupos. Los resultados embriológicos no fueron significativamente diferentes entre los grupos. Los presentes resultados sugieren que los pacientes con teratozoospermia moderada y grave pueden ser tratados eficazmente con FIV, realizándose R-ICSI cuando sea necesario.

Sperm morphological parameters; In vitro fertilization; Intracytoplasmic sperm injection; Teratozoospermia; Male infertility

Palabras Clave

Parámetros morfológicos espermáticos; Fecundación in vitro; Inyección intracitoplasmática de espermatozoides; Teratozoospermia inyección intracitoplasmática de espermatozoides; Teratozoospermia; Infertilidad masculina

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