The Relationship Between The Outcome Of IVF And The Sperm Morphology Before And After Swim-up

ObjectiveIn this study,we could find the relationship between the sperm morphology after swim-up and the outcome of IVF-ET by means of evaluating the morphology through strict criteria.And we also could compare it with the one between the sperm morphology before swim-up and the outcome in order to provide an accurate indicator for couples with female infertility due to bilateral tubal damage.MethodAfter evaluating the sperm morphologic features by Kruger criteria,we used 10%of normal morphologic features as the threshold to divide all the men into two groups:in groupⅠthe percentage normal morphologic features was≥10%and in groupⅡ,＜10%.We defined unit A before swim-up and unit B after swim-up.And the differences of the ages and FSH of female,the oocytes obtained and the parameters of the semen between the two groups of each unit had no significance.ResultThe mean fertilization rate was 72.15%,and the 95%confidence interval was(68.84%, 75.46%).The mean cleavage rate was 95.45%,and the 95%confidence interval was(93.49%, 97.40%).The mean gradeⅠembryo rate was 21.83%,and the 95%confidence interval was (17.78%,25.88%).The mean implantation rate and pregnancy rate were 19.70%(40/203)and 40.66%(37/91)respectively.In groupⅠof unit A,the fertilization rate,the cleavage rate and the gradeⅠembryo rate were 72.90%±4.234%,95.20%±2.607%and 23.35%±5.194%respectively.The clinical pregnancy rate was 39.58%and the implantation rate was 18.35%.In groupⅡof unit A,the fertilization rate,the cleavage rate and the gradeⅠembryo rate were 71.33%±5.096%,95.71%±2.881%and 20.18%±6.154%respectively.The clinical pregnancy rate was 41.86%and the implantation rate was 21.28%.No matter in groupⅠorⅡof unit A,the difference between the two groups had no significance(p＞0.05).In groupⅠof unit B,the fertilization rate and the cleavage rate were 72.72%±3.352%and 95.64%±2.038%respectively.The gradeⅠembryo rate was 24.39%±4.567%.The clinical pregnancy rate was 50%and the implantation rate was 23.87%.In groupⅡof unit B,the fertilization rate and the cleavage rate were 70.27%±8.820%and 94.82%±4.939%respectively.The gradeⅠembryo rate was 13.45%±7.389%.The clinical pregnancy rate was 9.52%and the implantation rate was 6.25%.After swim-up,the gradeⅠembryo rates,implantation rates and pregnancy rates in groupⅠwere marked higher than groupⅡ.The differences between them were quite significant(p＜0.05).While there was no significant difference of fertilization rate and cleavage rate between the two groups after swim-up.ConclusionPercentage normal morphologic features before swim-up cannot predict the outcome of IVF-ET.The morphologic features after swim-up is considered to be excellent tools to predict the rates of gradeⅠembryo,implantation and pregnancy of patients who are going to undergo an IVF-ET cycle.Sperm morphology is considered to have close connection with genetic information. It can affect the development of zygote and embryo.For couples with female infertility due to bilateral tubal damage only,if the percentage normal morphologic features after swim-up is≥10%, they can be suggested to take part in a IVF-ET cycle;if the percentage is＜10%,they had better to join another assistant reproductive programme in order to obtain a better result.