Correlation between sperm morphology using strict criteria in original semen and swim-up inseminate and human in vitro fertilization.

To study the value of sperm morphology using strict criteria in raw semen and in swim-up inseminate of human in vitro fertilization (IVF), 135 cycles of IVF with normal sperm concentration and motility were recruited. At least two mature oocytes were recovered in each cycle. The correlation between the percentages of normal forms and fertilization rates of mature oocytes was analyzed. The results demonstrate that the percentage of normal forms in both the raw semen and swim-up sample of patients with poor fertilization was significantly lower than in those with acceptable fertilization. The percentages of normal forms both in raw semen and in swim-up sample were significantly correlated with fertilization rates in vitro, however, the former seemed to have a better correlation (r = .51 and .19, respectively). Regarding the percentages of normal forms in raw semen, the fertilization rate in patients with normal forms < 4% was 6 +/- 11%, for 4-14% it was 58 +/- 36%, and for > 14% it was 88 +/- 20%. The fertilization rates were significantly different among these three groups of patients. The evaluation of sperm morphology using strict criteria in raw semen before IVF is predictive of fertilization outcome and may also help doctors to choose an optimal method of treatment for patients.