MP30-15 THE QUESTIONABLE CLINICAL UTILITY OF SPERM MORPHOLOGY: RATE OF ISOLATED TERATOSPERMIA IN A POPULATION OF FERTILE MEN

Abstract

You have accessJournal of UrologyCME1 Apr 2023MP30-15 THE QUESTIONABLE CLINICAL UTILITY OF SPERM MORPHOLOGY: RATE OF ISOLATED TERATOSPERMIA IN A POPULATION OF FERTILE MEN David Miller, Lucille Cheng, Anna Wecht, and Kathleen Hwang David MillerDavid Miller More articles by this author , Lucille ChengLucille Cheng More articles by this author , Anna WechtAnna Wecht More articles by this author , and Kathleen HwangKathleen Hwang More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003258.15AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: The assessment of sperm morphology remains a standard component of the semen analysis however its clinical utility is not well-defined. The WHO guidelines have progressively decreased the percentage of normal morphology over the years and the current provided reference range is 4% or greater. Despite these increasingly strict criteria for the assessment of morphology the clinical relevance remains questionable. Furthermore, accurate repeatability of sperm morphology assessment has been shown to be low due to differences in proficiency between labs and technicians themselves. To better understand the impact of sperm morphology on fertility we assessed sperm morphology in a population of known fertile men. METHODS: Healthy men over 18 years of age were recruited to provide one semen sample prior to vasectomy from 3/2020 to 8/2022. To be included in the study participants were required to have biological children under the age of 5 years old, with no history of difficulty achieving pregnancy, and had undergone no prior fertility procedures. Sperm morphology was analyzed using Papanicolaou stain with Kruger strict criteria by two technicians in an Andrology specialty laboratory per the WHO 5th edition manual. RESULTS: There were 65 men who participated in the study, of which there was a morphology assessment available for 65 patients. The average age of participants was 36 and the mean BMI was 27.9 (20-43.7). Of those with smoking history available, 61% of men were non-smokers, 20% were former smokers, and 13% were current smokers. Patients had an average of 2.7 children with a mean age of the youngest child of 15 months old. The mean sperm density was 57.3 mil/ml, the mean motility was 61%, and mean progressive motility was 76%. The median morphology was 3%. There were 33 patients (51%) with 3% or lower sperm morphology including one patient who had 0% normal morphology (Figure 1). The most common morphologic abnormalities were head shape defects (n=58), followed by coiled tails (n=15) with some patients having both abnormalities. CONCLUSIONS: Over half of fertile male patients had lower than normal sperm morphology in our study. The results of our study further question the clinical relevance of sperm morphology on fertility outcomes and if the current approach in assessing morphology is too strict. Source of Funding: none © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e396 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information David Miller More articles by this author Lucille Cheng More articles by this author Anna Wecht More articles by this author Kathleen Hwang More articles by this author Expand All Advertisement PDF downloadLoading ...