Yi Shiqi, Yang Li, Yang Yihong, Wei Fan, Zhun Xiao, Wang Yan
Center for Translational Medicine, Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, West China Second University Hospital, Sichuan University, Chengdu, 610041, Sichuan, China.
Department of Obstetrics and Gynecology, West China Second Hospital, Sichuan University, Chengdu, 610041, Sichuan, China.
J Assist Reprod Genet. 2025 Mar 31. doi: 10.1007/s10815-025-03453-1.
On the day of fresh oocyte retrieval in in vitro fertilization (IVF) cycles, a novel portable artificial intelligence optical microscope (AIOM) was employed to assist in the assessment of semen parameters. This study analyzed the correlation between sperm kinetic and morphological parameters with short-term IVF outcomes. Additionally, it explored whether these parameters could serve as predictive indicators for rescue intracytoplasmic sperm injection (R-ICSI) in IVF patients.
A retrospective analysis was conducted on patients undergoing short-term IVF at the West China Second Hospital of Sichuan University between May 2021 and May 2024. Based on fertilization outcomes, the short-term IVF patients were categorized into a successful fertilization group (group A, n = 281) and a group requiring R-ICSI after failed fertilization (group B, n = 49). AIOM was utilized to analyze semen parameters including pH, sperm concentration, sperm motility parameters, sperm movement trajectory parameters, and sperm morphological parameters. The study further investigated the correlation between these short-term IVF fertilization-related laboratory indicators and IVF outcomes.
No statistically significant difference was observed in semen pH between the two groups. However, there were significant differences in sperm concentration and the majority of motility parameters. Specifically, compared to group A, patients in group B exhibited lower sperm concentration (p = 0.01), motility (p = 0.01), local motility (p = 0.01), progressive motility (PR) (p = 0.00), total motility (p = 0.01), and amplitude of lateral head displacement (ALH) (p < 0.01), along with higher immotility (p = 0.00). No statistically significant differences were found between the two groups in other sperm motility, velocity, or trajectory parameters. Additionally, sperm morphological parameters were also associated with short-term IVF fertilization outcomes. Compared to group A, group B had higher sperm head length mean (p < 0.01), head perimeter mean (p < 0.01), and head area mean (p = 0.01), as well as lower tail length mean (p = 0.01). Multivariate regression analysis of fertilization outcomes indicated that higher immotility (p = 0.01) and head length mean (p < 0.01), along with lower tail length mean (p = 0.04), were independent risk factors affecting successful short-term IVF fertilization. Notably, head length mean showed a significant negative correlation with polyspermy rate (p < 0.01), whereas tail length mean was significantly positively correlated with polyspermy rate (p < 0.01).
Optimization of semen parameters with AIOM at the time of fertilization is significantly associated with short-term IVF fertilization outcomes. Abnormal semen parameters at fertilization-specifically, higher immotility and head length mean, along with lower tail length mean-can be considered risk factors for fertilization failure and may serve as predictive indicators for potential R-ICSI.
在体外受精（IVF）周期中新鲜取卵日，采用一种新型便携式人工智能光学显微镜（AIOM）辅助评估精液参数。本研究分析了精子动力学和形态学参数与短期IVF结局之间的相关性。此外，还探讨了这些参数是否可作为IVF患者补救性卵胞浆内单精子注射（R-ICSI）的预测指标。
对2021年5月至2024年5月在四川大学华西第二医院接受短期IVF的患者进行回顾性分析。根据受精结局，将短期IVF患者分为成功受精组（A组，n = 281）和受精失败后需要R-ICSI的组（B组，n = 49）。利用AIOM分析精液参数，包括pH值、精子浓度、精子活力参数、精子运动轨迹参数和精子形态参数。该研究进一步调查了这些短期IVF受精相关实验室指标与IVF结局之间的相关性。
两组之间精液pH值无统计学显著差异。然而，精子浓度和大多数活力参数存在显著差异。具体而言，与A组相比，B组患者的精子浓度较低（p = 0.01）、活力较低（p = 0.01）、局部活力较低（p = 0.01）、前向运动（PR）较低（p = 0.00）、总活力较低（p = 0.01）和头部侧摆幅度（ALH）较低（p < 0.01），而不动率较高（p = 0.00）。两组在其他精子活力、速度或轨迹参数方面未发现统计学显著差异。此外，精子形态参数也与短期IVF受精结局相关。与A组相比，B组的精子头部平均长度较长（p < 0.01）、头部平均周长较长（p < 0.01）和头部平均面积较大（p = 0.01），而尾部平均长度较短（p = 0.01）。受精结局的多因素回归分析表明，较高的不动率（p = 0.01）和头部平均长度（p < 0.01），以及较低的尾部平均长度（p = 0.04）是影响短期IVF受精成功的独立危险因素。值得注意的是，头部平均长度与多精受精率呈显著负相关（p < 0.01），而尾部平均长度与多精受精率呈显著正相关（p < 0.01）。
受精时利用AIOM优化精液参数与短期IVF受精结局显著相关。受精时精液参数异常，特别是较高的不动率和头部平均长度，以及较低的尾部平均长度，可被视为受精失败的危险因素，并可能作为潜在R-ICSI的预测指标。
