This study was performed to establish the normal fertile range in the results of the sperm morphology evaluation using strict criteria and to evaluate this test as a prognostic indicator in an in vitro fertilization comparing with the sperm
zona-free
hamster ova penetration assay(SPA). Fourty fertility-proven men and 58 couples applying to in vitro fertilization were allocated to the study group in a prospective way. All female partners in these couples had tubal infertility and were less
than
35
years old, and males had the sperm concentration≥5×10E6/ml and the sperm motility≥10%. The normal sperm morphology and morphology index (summation of normal and slightly amorphous forms) could be established with a cutoff figure at the 2.5%
and
5.5%.
The positive predictive value, negative predictive value, sensitivity and specificity of normal sperm morphology in predicting in vitro fertilization were 89.2%, 90.5%, 94.3% and 82.6%. The values of sperm morphology index were 91.2%, 83.3%,
88.6%
and
87.0%. the positive predictive value and specificity of the test were lower than those of sperm penetration index(100.0%, 100.0%) but the negative predictive value and sensitivity were between than those of sperm penetration index (79.3%, 75.0%).
Fifty-eight patients applying to in vitro fertilization were divided into two groups: group 1, 35 patients (fertilization of at least one oocyte) and group 2, 23 patients(no fertilization). The percent of normal sperm morphology, morphology index
and
sperm penetration index were significantly higher in group 1 compared with group 2. In group 1, there were significant correlations among normal sperm morphology, morphology index and serpm motility. In group 2, there was no correlation among any
sperm
parameters. In group 1, there were significant correlation between fertilization rate and sperm motility, fertilization rate and sperm penetration index, fertilization rate and normal sperm morphology, and fertilization rate and morphology index.
It is
concluded that the pserm morphology evaluation strict criteria is simple, inexpensive and useful as a prognostic indicator of sperm fertilizing capacity in in vitro fertilization.
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