Which sperm parameter limits could really guide the clinical decision in assisted reproduction?

The predictive role of sperm motility and morphology was recently detected in a large sample of more than 20000 assisted reproductive technology (ART) fresh cycles. However, the complete ART procedure consisted both fresh and frozen-embryos transfers and only a comprehensive evaluation of the entire process could really confirm if these parameters really predict the ART success. The aim of the study was to evaluate which sperm parameter could predict the success of assisted reproductive technology (ART).

A retrospective, real world data analysis was performed, enrolling all couples attending ART from 2008 to 2021, including both fresh and frozen cycles and both in vitro fertilization (IVF) and intra-cytoplasmic sperm injection (ICSI) procedures.

Fresh cycles success (considering LBR) was predicted by female age (1.04 [1.02-1.06]), injected oocytes (0.96 [0.93-0.99]), embryo number (0.79 [0.75-0.83]) and progressive sperm motility (0.98 [0.97-0.99]). On the contrary, frozen cycles outcomes were predicted only by sperm motility (0.97 [0.95-0.99]). This prediction was confirmed in IVF but not in ICSI cycles.

Both female and male's parameters predicted the ART success considering the entire path. However, frozen cycles success was predicted only by progressive sperm motility in IVF cycles, suggesting that the potential amelioration of this male parameter is relevant to improve ART success. Those couples expected to obtain highest embryos after fertilization (low female age and better semen parameters) will have more attempts with frozen cycles and thus would benefit of a potential treatment focused to improve sperm parameters. This article is protected by copyright. All rights reserved.

Andrology. 2022 Oct 17 [Epub ahead of print]

Daniele Santi, Giorgia Spaggiari, Daria Morini, Beatrice Melli, Leonardo Dalla Valentina, Lorenzo Aguzzoli, Manuela Simoni, Maria Teresa Villani

Unit of Endocrinology, Department of Medical Specialties, Azienda Ospedaliero-Universitaria of Modena, Ospedale Civile of Baggiovara, Modena, Italy., Department of Obstetrics and Gynaecology, Fertility Centre, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Arcispedale Santa Maria Nuova, Reggio Emilia, Italy.