Ombelet W, Fourie F L, Vandeput H, Bosmans E, Cox A, Janssen M, Kruger T
Genk Institute for Fertility Technology, St.-Jansziekenhuis, Belgium.
Hum Reprod. 1994 Aug;9(8):1479-84. doi: 10.1093/oxfordjournals.humrep.a138734.
A prospective randomized study was conducted to assess the prognostic value of sperm morphology in an in-vitro fertilization (IVF) programme, using strict criteria. The first group (T, teratozoospermic) included 32 couples with an isolated teratozoospermia in the male partner (morphology < 9% normal). The second group (C, control) contained 36 couples with normal semen parameters, including morphology (> 9% normal, strict criteria). In both groups, 50 IVF cycles were performed. Patients were matched for indication for IVF. There was no difference between the two groups regarding age, duration of infertility, stimulation protocol, catheter used for embryo transfer and different sperm parameters. A statistically significant difference between the T and C groups respectively was observed regarding the fertilization rate (69.2 and 79.4%, P < 0.05), pregnancy rate per cycle (12.0 and 42%, P < 0.001), the pregnancy rate per transfer (13.9 and 42.0%, P < 0.01) and per embryo transferred (6.1 and 14.8%, P < 0.05). No pregnancy occurred in the poor prognosis group (morphology < 5% normal). In cases of moderate teratozoospermia, the fertilization rate appeared normal (78.6%) but the conception rate remained low. We concluded that the use of strict criteria in the assessment of sperm morphology is useful in predicting fertilization and pregnancy rate in the human in-vitro model.
一项前瞻性随机研究采用严格标准，在体外受精（IVF）程序中评估精子形态的预后价值。第一组（T组，畸形精子症组）包括32对夫妇，男性伴侣为单纯畸形精子症（形态正常的精子<9%）。第二组（C组，对照组）包含36对精液参数正常的夫妇，包括形态（形态正常的精子>9%，严格标准）。两组均进行了50个IVF周期。患者根据IVF指征进行匹配。两组在年龄、不孕持续时间、刺激方案、胚胎移植所用导管和不同精子参数方面无差异。T组和C组在受精率（分别为69.2%和79.4%，P<0.05）、每个周期的妊娠率（分别为12.0%和42%，P<0.001）、每次移植的妊娠率（分别为13.9%和42.0%，P<0.01）以及每个移植胚胎的妊娠率（分别为6.1%和14.8%，P<0.05）方面分别观察到统计学上的显著差异。预后不良组（形态正常的精子<5%）未发生妊娠。在中度畸形精子症病例中，受精率似乎正常（78.6%），但受孕率仍然较低。我们得出结论，在评估精子形态时使用严格标准有助于预测人类体外模型中的受精率和妊娠率。
