RESUMO
BACKGROUND: Sperm morphology has been strongly linked to fertilization. This makes it an important component in semen analysis. They are usually assessed by world health organization (WHO) standard or Kruger strict criteria in in-vitro fertilization (IVF) centers all over the world. Sperm count, motility, and morphology together form the basis by which patients are allocated into IVF or intra-cytoplasmic sperm injection. OBJECTIVE: This study aimed to compare fertilization rates in standard IVF from patients with normal sperm count and motility with and without morphological assessment by WHO guideline. MATERIALS AND METHODS: In this prospective cohort study, sperm count, motility, and morphology of 504 men candidate for IVF program over a three years period in our center were evaluated in two groups: Group A (case group) included men with normal sperm count and motility but with a poor morphology and group B (control group) included men with normal sperm count, motility and morphology evaluated by WHO criteria. Fertilization rate in both groups were then analyzed after 16-18 hr post insemination. RESULTS: Fertilization rate was higher in group B (p=0.028). Participants in group B, apart from having a normal sperm count (32.9±7.2) and motility (62.4±8.9), have a strict morphology of ≥30%. Our result has shown that spermatozoa in group B had a higher fertilization rate (71.4%). Though the sperm count (36.4±6.7) and motility (66.3±7.4) in group A were slightly higher (p=0.058 and p=0.060 respectively) than group B, the fertilization rate was lower. CONCLUSION: Our study showed that sperm morphology could be a very important consideration before decisions towards allocation of patients into IVF or intra-cytoplasmic sperm injection.
RESUMO
OBJECTIVE: Several publications have established a relationship between sperm DNA damage and male factor infertility, based on data from America, Europe, and Asia. This study aimed to compare the extent of sperm DNA damage in sperm samples from Nigerian men with unexplained infertility and in sperm samples from a fertile group composed of sperm donors who had successfully impregnated a female partner naturally or through assisted conception. METHODS: A total of 404 men underwent male fertility evaluation at Androcare Laboratories and Cryobank participated in this study. Semen analysis and a sperm chromatin structure assay (SCSA) were performed on all subjects. RESULTS: The men in the unexplained infertility group were slightly older than the men in the fertile sperm group (36+/-10 years vs. 32+/-6 years, p=0.051). No significant difference was observed between the two groups in semen analysis parameters (p> or =0.05). Men in the unexplained infertility group with normal semen parameters had a significantly higher DNA fragmentation index (DFI) than men in the fertile sperm group (27.5%+/-7.0% vs. 14.1%+/-5.3%, p<0.05). In the unexplained infertility group, 63% of the men had a DFI greater than 20%, compared to 4% in the fertile sperm group. In the unexplained infertility group, 15.2% of the subjects had a DFI greater than 30%, compared to 1% in the fertile sperm group. CONCLUSION: Our study showed that the SCSA may be a more reliable predictor of fertility potential than traditional semen analysis in cases of unexplained infertility.
