Assistant Professor, Unidad de Reproducción Asistida Hospital Universitario La Plana de Vila-real.
Assistant Professor, Servicio de Obstetricia y Ginecología del Hospital Universitario La Plana de Vila-real, Castellón, Spain.
Obstet Gynecol Surv. 2021 Mar;76(3):170-174. doi: 10.1097/OGX.0000000000000871.
The value of morphology as a sperm parameter remains uncertain. Many studies have addressed the importance of morphology to predict the success of intrauterine insemination (IUI), but with conflicting results.
The aims of this study were to review the current literature, to query our own clinical experience via a retrospective, descriptive study, and to determine whether the diagnosis of isolated teratozoospermia influences pregnancy rate after IUI.
We identified a large number of studies addressing this question. All were retrospective and most used different criteria to assess sperm morphology. Further complicating matters, the cutoff for normal morphology decreased from 15% to 4%. In our patient population, we found 12 cases of isolated teratozoospermia (10.43%). Only one of these produced an ongoing pregnancy and live birth. In all other cases, alteration of other sperm parameters coexisted (89.57%). These cycles produced a pregnancy rate of 13%, a nonsignficant difference. Pregnancy rates also were analyzed according to the percentage of normal morphology: 35.71% for less than 4%, 50% for 5% to 9%, and 14.29% for 10% to 14%. These rates did not differ significantly.
No consistent effect of sperm morphology on pregnancy rate was found in either the published literature or our own clinical experience. Larger and prospective studies are needed to identify any subtle effects of morphology on IUI outcomes that might exist.
形态作为精子参数的价值仍然不确定。许多研究已经探讨了形态对预测宫腔内人工授精（IUI）成功的重要性，但结果存在冲突。
本研究旨在回顾当前文献，通过回顾性描述性研究查询我们自己的临床经验，并确定是否诊断为单纯畸形精子症会影响 IUI 后的妊娠率。
我们确定了大量研究这个问题的研究。所有这些研究都是回顾性的，大多数使用不同的标准来评估精子形态。进一步复杂化的是，正常形态的截止值从 15%降至 4%。在我们的患者人群中，我们发现了 12 例单纯畸形精子症（10.43%）。只有一个产生了持续妊娠和活产。在所有其他情况下，其他精子参数的改变同时存在（89.57%）。这些周期的妊娠率为 13%，无显著差异。还根据正常形态的百分比分析了妊娠率：小于 4%为 35.71%，5%至 9%为 50%，10%至 14%为 14.29%。这些比率没有显著差异。
在已发表的文献或我们自己的临床经验中，均未发现精子形态对妊娠率有一致的影响。需要更大和前瞻性的研究来确定形态对 IUI 结果可能存在的任何细微影响。
