title: Isolated teratozoospermia does not affect in vitro fertilization outcome and is not an indication for intracytoplasmic sperm injection.
abstract: OBJECTIVE
  To reevaluate clinical management of isolated teratozoospermia, in couples initiating IVF.
  
  
  METHODS
  Retrospective analysis of fertility indices in 535 cycles.
  
  
  METHODS
  A large, university-based fertility center.
  
  
  METHODS
  Consecutive couples (n = 495) who had a semen analysis using Kruger/Tyberberg strict criteria at our center within 12 months before undergoing their first and/or second IVF cycle in 2002-2004 with >2 million postwash, motile sperm on the day of egg retrieval.
  
  
  METHODS
  Eggs were fertilized either by conventional IVF or ICSI. Semen analysis and gamete/embryo manipulation was standardized in all cases.
  
  
  METHODS
  Fertilization, fertilization failure, pregnancy, and live birth rates.
  
  
  RESULTS
  There was no statistical difference in fertilization, fertilization failure, pregnancy, and live birth rates in the first or second IVF cycle when comparing couples with isolated teratozoospermia (<5% normal morphology) to those with a normal semen analysis. Furthermore, no improvement in these outcomes was noted when ICSI was used to treat these teratozoospermic couples.
  
  
  CONCLUSIONS
  Because isolated teratozoospermia generally does not impact on the major indices of IVF, these patients need not be subjected to the unnecessary cost and potential risks of ICSI. Future studies, however, should focus on different sperm morphologic and biochemical parameters to determine if they are important for clinical management in IVF.
authors: NYU Fertility Center, New York University School of Medicine, New York, New York 10016, USA. brian.keegan@med.nyu.edu
authors: Brian Robert
authors: BR
authors: Keegan
authors: Sara
authors: S
authors: Barton
authors: Xavier
authors: X
authors: Sanchez
authors: Alan S
authors: AS
authors: Berkeley
authors: Lewis C
authors: LC
authors: Krey
authors: Jamie
authors: J
authors: Grifo
mesh_terms: D000328:Adult; D001723:Birth Rate; D048430:Cell Shape; D005260:Female; D005307:Fertilization in Vitro; D006801:Humans; D007248:Infertility, Male / Q000209:etiology / Q000628:therapy*; D008297:Male; D011247:Pregnancy; D012189:Retrospective Studies; D020554:Sperm Injections, Intracytoplasmic; D013094:Spermatozoa / Q000002:abnormalities* / Q000166:cytology; D016896:Treatment Outcome