Abstract
Purpose
To investigate the effect of sperm concentration, motility and advanced paternal age on reproductive outcomes.
Methods
A retrospective analysis of 1266 intracytoplasmic sperm injection (ICSI) cycles between 2013 and 2017. The cohort was divided into four groups according to semen concentration based on the WHO criteria (2010): group A (conc. <1 M/ml), group B (1 ≤ conc. <5 M/ml), group C (5 ≤ conc. < 15 M/ml) and the control group D (conc. ≥15 M/ml). The primary outcome investigated was the blastulation rate. Secondary outcomes were fertilization rate, top quality blastocyst formation rate and ongoing pregnancy rate.
Results
After adjustment for maternal age and number of oocytes recovered, a significant difference was observed between group A and group D on the rate of fertilized oocytes [66.7 (40.0–80.0) vs 75.0 (57.1–90.2), adjusted p < 0.001] and the blastocyst formation rate [50.0 (33.3–66.3) vs 55.6 (40.0–75.0), adjusted p < 0.05]. However, the male factor did not affect the top quality blastocyst formation rate nor the ongoing pregnancy rate. Considering the age of the male partner as confounding factor, at the increase of each year of age, a reduction of 0.3% on the fertilization rate was observed but no other outcome was impacted. A negative correlation was also observed between sperm motility and fertilization rate in the group with a motility <5%.
Conclusion
Male factor infertility and advanced paternal age may compromise fertilization and blastulation rates but not top quality blastocyst formation rate or the establishment of pregnancy in ICSI cycles.
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E.P. reports consultancies with MSD, Merck-Serono, Ferring, and IBSA Institut Biochimique SA; grants from MSD, Merck-Serono, Ferring, IBSA Institut Biochimique SA and FINOX; honoraria from MSD, Merck-Serono, and Ferring; and travel expenses paid by MSD, Merck-Serono, Ferring, and IBSA Institut Biochimique SA. All the other authors declare no conflict of interest.
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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
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Supplementary Fig. 1
Representation of the dimension reduction obtained by Principal Component Analysis to resume the complexity of information related to the female partner. PC Principal Component. (PDF 137 kb)
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Bartolacci, A., Pagliardini, L., Makieva, S. et al. Abnormal sperm concentration and motility as well as advanced paternal age compromise early embryonic development but not pregnancy outcomes: a retrospective study of 1266 ICSI cycles. J Assist Reprod Genet 35, 1897–1903 (2018). https://doi.org/10.1007/s10815-018-1256-8
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DOI: https://doi.org/10.1007/s10815-018-1256-8