Men with a complete absence of normal sperm morphology exhibit high rates of success without assisted reproduction

Asian J Androl. 2017 Jan-Feb;19(1):39-42. doi: 10.4103/1008-682X.189211.

Abstract

In couples with infertility, abnormal strict morphology of 0% normal forms (NF) is a criterion to proceed rapidly to in vitro fertilization (IVF). Since no data currently exist, we investigated the outcomes for men with 0% NF to determine reproductive success without the use of assisted reproductive technologies (ART). A cohort of 24 men with 0% NF were identified (2010-2013) with 27 randomly selected men with ≥4% NF as controls. Patient charts were reviewed with men contacted and administered an Institutional Review Board (IRB)-approved telephone questionnaire to ascertain outcomes. After a median follow-up time of 2.5 years, 29.2% of men with 0% NF did not require ART for their first pregnancy (controls = 55.6%, P ≤ 0.05). When all pregnancies were analyzed together, men with 0% NF achieved twenty pregnancies of which 75% did not require IVF (controls = thirty pregnancies; 76.7% did not require IVF). The average age of men and female partners was similar between men with 0% NF and ≥4% NF. All men had normal follicle-stimulating hormone (FSH), testosterone, prolactin, sex hormone-binding globulin (SHBG), and estradiol. Although, global semen parameters were worse in men with 0% NF, when a first pregnancy was a natural conception (NC), 100% of men with 0% NF (n = 7/7) and 37.5% of controls (n = 3/8) went on to have a subsequent pregnancy via NC. Men with 0% NF conceived without IVF in 29.2% of cases compared to 55.6% of controls. Strict morphology should not be used to predict fertilization, pregnancy, or live birth potential. In men with 0% NF, alternative modalities should be considered before immediate IVF.

MeSH terms

  • Adult
  • Case-Control Studies
  • Estradiol / metabolism
  • Female
  • Fertilization in Vitro / statistics & numerical data*
  • Follicle Stimulating Hormone / metabolism
  • Follow-Up Studies
  • Humans
  • Luteinizing Hormone / metabolism
  • Male
  • Pregnancy
  • Pregnancy Rate*
  • Prolactin / metabolism
  • Reproductive Techniques, Assisted / statistics & numerical data
  • Severity of Illness Index
  • Sex Hormone-Binding Globulin / metabolism
  • Spermatozoa / abnormalities
  • Teratozoospermia / metabolism
  • Teratozoospermia / physiopathology*
  • Testosterone / metabolism

Substances

  • Sex Hormone-Binding Globulin
  • Testosterone
  • Estradiol
  • Prolactin
  • Luteinizing Hormone
  • Follicle Stimulating Hormone