title: Influence of individual sperm morphology on fertilization, embryo morphology, and pregnancy outcome of intracytoplasmic sperm injection.
abstract: OBJECTIVE
  To evaluate the influence of morphology of individual spermatozoa on fertilization and pregnancy outcome.
  
  
  METHODS
  Retrospective analysis.
  
  
  METHODS
  An IVF center in an institutional research environment.
  
  
  METHODS
  Fertilization and embryo quality according to individual sperm morphology were analyzed in 662 consecutive ICSI cycles. Pregnancy outcome was evaluated for these cycles and an additional 1005 consecutive ICSI cycles.
  
  
  METHODS
  ICSI was performed using sperm cells of ejaculated, epididymal, or testicular origin. Observation through an inverted microscope was used to prospectively classify injected sperm cells as normal or morphologically abnormal.
  
  
  METHODS
  Oocyte fertilization, embryo morphology, and pregnancy outcome of unmixed embryo transfers.
  
  
  RESULTS
  Injection of morphologically abnormal spermatozoa (irrespective of origin) resulted in a lower fertilization rate (60.7%) than did injection of morphologically normal spermatozoa (71.7%). Embryo cleavage quality did not differ between groups. Higher pregnancy and implantation rates were obtained in patients with normal sperm morphology (36.7% and 18.7%, respectively) than in those with abnormal sperm morphology (20.2% and 9.6%).
  
  
  CONCLUSIONS
  Individual sperm morphology assessed at the moment of ICSI correlated well with fertilization outcome but did not affect embryo development. The implantation rate was lower when only embryos resulting from injection of an abnormal spermatozoon were available.
authors.affiliation: Centre for Reproductive Medicine, University Hospital, Dutch-speaking Brussels Free University, Brussels, Belgium. Iriadvsa@az.vub.ac.be
authors.forename: Anick
authors.initials: A
authors.lastname: De Vos
authors.forename: Hilde
authors.initials: H
authors.lastname: Van De Velde
authors.forename: Hubert
authors.initials: H
authors.lastname: Joris
authors.forename: Greta
authors.initials: G
authors.lastname: Verheyen
authors.forename: Paul
authors.initials: P
authors.lastname: Devroey
authors.forename: André
authors.initials: A
authors.lastname: Van Steirteghem
mesh_terms: D004542:Ejaculation; D010064:Embryo Implantation; D004822:Epididymis / Q000166:cytology; D005260:Female; D005306:Fertilization; D006801:Humans; D008297:Male; D011247:Pregnancy; D011256:Pregnancy Outcome; D012189:Retrospective Studies; D020554:Sperm Injections, Intracytoplasmic; D013094:Spermatozoa / Q000002:abnormalities* / Q000502:physiology*; D013737:Testis / Q000166:cytology; D020858:Tissue and Organ Harvesting