Isolated teratozoospermia does not affect in vitro fertilization outcome and is not an indication for intracytoplasmic sperm injection.
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.
Keegan
Brian Robert
BR
NYU Fertility Center, New York University School of Medicine, New York, New York 10016, USA. brian.keegan@med.nyu.edu
Barton
Sara
S
Sanchez
Xavier
X
Berkeley
Alan S
AS
Krey
Lewis C
LC
Grifo
Jamie
J
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