The relationship between the sperm quality and fertilization outcome after short-time insemination

Abstract

Objective To evaluate the predictive value of the sperm quality to fertilization outcomes after short-time insemination. Methods A total of 558 cycles of short-time insemination in the Reproductive Medical Center of Henan Provincial People′s Hospital during January 2009 to June 2010 excluding patients aged >38 years and M II oocyte number <3 were analyzed retrospectively.According to whether undergo rescue intracytoplasmic sperm injection(Re-ICSI), all cycles were divided into in vitro fertilization (IVF) group (472 cycles) and rescue intracytoplasmic sperm injection (Re-ICSI) group(86 cycles).Both IVF group and Re-ICSI group were subdivided into primary infertility and secondary infertility according to previous history of pregnancy.269 primary infertility cycles and 203 secondary infertility cycles were characterized in IVF group; and 64 primary infertility cycles and 22 secondary infertility cycles were characterized in Re-ICSI group.χ2 test was applied for comparison of embryo plant rate, clinical pregnancy rate, early miscarriage rate between IVF and Re-ICSI groups , while Fisher test was used for comparison of live birth rate.and Mann-Whitney U test was utilized for comparison of duration of infertility, forward moving sperm counts, abnormal sperm rate, sperm acrosin activity between IVF and Re-ICSI groups. Results The embryo plant rate, clinical pregnancy rate, early miscarriage rate, live birth rate of IVF group were: 29.4%, 44.9%, 13.4%, 37.0% respectively；the above indicators in Re-ICSI group were: 25.7%, 34.6%, 10.7%, 29.6% respectively, the differences of the indicators between the two groups had no statistical significance（χ2=0.869, 2.963, 0.010, P=0.351, 0.085, 0.922, 0.098）.Median of duration of infertility, forward moving sperm counts, abnormal sperm rate, sperm acrosin activity of primary infertility cycles in IVF group were:4.00(3.00-6.00) years, 58.37(33.64-102.27)×106, 81.09%(79.41%-88.69%), 76.30(48.50-92.46) μIU/106 sperm respectively; in Re-ICSI group were: 5.00(3.25-8.00) years, 36.33(20.59-64.43)×106, 85.5%(81.28%-89.02%), 47.14(31.61-90.24) μIU/106 sperm respectively, the differences of them between the two groups had statistical significance（Z=-2.617, -3.505, -3.553, -3.530, P=0.009, 0.000, 0.000, 0.000）.Median of duration of infertility, forward moving sperm counts, abnormal sperm rate, sperm acrosin activity of secondary infertility cycles in IVF group were: 5.00(3.00-7.00) years, 63.00(34.20-107.73)×106, 81.29%(79.90-86.09）%, 78.34 (53.87-98.00) μIU/106 sperm respectively, in Re-ICSI group were: 5.00(3.75-7.00) years, 28.80(18.57-48.56)×106, 88.79%(84.04-95.64)%, 54.70(39.73-76.77) μIU/106 sperm respectively, the differences of them between the two groups showed statistical significance except duration of infertility (Z=-0.338, -3.505, -3.553, -3.530, P=0.735, 0.000, 0.000, 0.006）. Conclusion The duration of infertility, forward moving sperm counts, abnormal sperm rate, sperm acrosin activity have predictive value of fertilization outcomes after short-time insemination.(Chin J Lab Med, 2012，35：150-155) Key words: Fertilization in vitro; Treatment failure; Sperm count; Acrosin; Forecasting