Strict Criteria Sperm Morphology for Infertility Diagnosis and Treatment, Semen
Infertility affects 1 out of 6 couples of child-bearing age. Approximately 40% of infertility has a female-factor cause and 40% a male-factor cause. The remaining 20% of infertility is due to a combination of male- and female-factor disorders or is unexplained.
Abnormalities in sperm morphology are related to: defects in sperm transport, sperm capacitation, the acrosome reaction, binding/penetration of the zona pellucida, and fusion with the oocyte vitelline membrane. All of these steps are essential to normal fertility.
Strict criteria sperm morphology testing also greatly assists with selecting the most cost-effective in vitro sperm processing and insemination treatment for the couple's IVF cycle. Sperm with severe head abnormalities are unlikely to bind to the zona pellucida. These patients may require intracytoplasmic sperm injection in association with their IVF cycle to ensure optimal levels of fertilization are achieved. This, in turn, provides the patient with the best chance of pregnancy.
Diagnosing male infertility
Selecting the most cost-effective therapy for treating male-factor infertility
Quantifying the number of germinal and WBCs per mL of semen
Categorizing sperm according to strict criteria based on measurements of head and tail sizes and shapes. Sperm with abnormalities in head/tail size/shape may not be capable of completing critical steps in sperm transport and fertilization.
Conventional semen analysis (FER / Semen Analysis) should be performed in conjunction with each strict criteria sperm morphology.
Normal forms: > or =4.5%
<4 x 10(6) (normal)
> or =4 x 10(6) (elevated germinal cells in semen are of unknown clinical significance)
<1 x 10(6) (normal)
> or =1 x 10(6) (elevated white blood cells in semen are of questionable clinical significance)
Clinical References Provides recommendations for further in-depth reading of a clinical nature
1. Kruger Morphology Conference, Boston, MA, October 9, 1993
2. The World Health Organization Laboratory Manual for the examination of human semen and sperm-cervical mucus interaction. Fifth Edition. Cambridge University Press, 2010