Prediction of in vitro fertilization success rates using post-preparation sperm parameters

Abstract

Objective: This study was initiated to assess the significance of individual sperm parameters after preparation, on percent fertilization, implantation rate, clinical pregnancy rate and live birth rate. Design: A retrospective evaluation of 218 couples undergoing in vitro fertilization from June 1997 to December 2000. Materials/Methods: IVF couples who had a sperm morphology evaluation, (using strict criteria), within three months of an oocyte retrieval were chosen for this study. Post-preparation sperm concentration, total progressive motility, and percent progressive motility values from the day of retrieval were analyzed in relationship to percent fertilization, implantation, clinical pregnancy, and live birth rates. Several different sperm preparation techniques were utilized depending on initial sperm parameters. Patients with less than three percent normal sperm forms were selected for intra cytoplasmic sperm injection. All 218 couples underwent a fresh embryo transfer. Results: Total progressive motility was positively correlated with fertilization rate (p <.01), clinical pregnancy rate (p <.01), and negatively correlated with live birth rate (p <.01). Total progressive motility had no statistical relationship with implantation rate. Percent motility was positively correlated with fertilization rates (p <.05). Implantation rates only correlated with age of the female patient (p <.05), and it was an inverse relationship, (as the patients got older implantation decreased). Sperm morphology and concentration were not predictors of fertilization, implantation, clinical pregnancy or live birth rates. Conclusions: Total progressive motility in the prepared sperm specimen was the single largest predictor of IVF outcome in the patient group evaluated. The negative relationship of total progressive motility to live birth outcome may be related to stronger female patient influences as the sperm parameters approach normal values. Supported by: Department of Obstetrics and Gynecology, Massachusetts General Hospital.