LOW PERCENTAGE MOTILITY WHEN SPERM CONCENTRATION IS NORMAL DOES NOT APPEAR TO BE A CAUSE OF UNEXPLAINED FAILURE TO HAVE A LIVE DELIVERY DESPITE IN VITRO FERTILIZATION (IVF)

Abstract

Some data suggest that sperm with very low motile density can lead to a trend for a lower chance of a live delivery following in vitro fertilization (IVF) with intracytoplasmic sperm injection (ICSI) even despite the transfer of embryos with apparent normal morphology. The purpose of the present study was to see if low % motility in the presence of normal sperm concentration can also be a subtle cause of unexplained infertility. Couples were identified who were sharing donor oocytes when both male partners had normal concentrations of their sperm (≥20x106/mL) but where one had motility <30% and the other ≥50%. Subsequent fertilization rates, embryo quality, as evidence by number of blastomeres on day 3 transfer, and pregnancy rates were determined. ICSI was used or not according to the discretion of the physician. Tabled 1Pregnancy rates based on % motility for shared oocyte cycles when sperm concentration ≥20 mill/mLMotility<30%≥50%# cycles3737% fertilized70.5%70.1%% 6-8 cell day 360.6%70.7%% clinical pregnancy/transfer58.3%68.0%% miscarriage/clinical pregnancy live0.0%35.3%% delivered58.3%44.0%% implantation31.3%40.0% Open table in a new tab There were no statistical differences or trends that would suggest that low % motile sperm, despite normal sperm concentration, leads to embryos with a lower chance to achieve a live delivery. With no trends seen at all, the study will not be continued. Based on other studies, there is a suggestion that sperm from men with very low motile density, used for IVF-ET, the embryos formed, though appearing to be morphologically normal, may be the cause of lower live delivered pregnancy rates. This raised the question as to the possibility that sperm with very low MD may be more likely to have chromosome defects. That data was also based on similar evaluation of matched pairs sharing one pool of oocytes, thus ruling out an oocyte factor. It does not seem that low percentage of sperm motility is a subtle cause of unexplained infertility when sperm concentration was normal based on this pilot study.