Sperm morphology: Classification drift over time and clinical implications

Department of Obstetrics and Gynecology, Mayo Clinic, Rochester, Minnesota 55905, USA.
Fertility and sterility (Impact Factor: 4.59). 09/2011; 96(6):1350-4. DOI: 10.1016/j.fertnstert.2011.08.036
Source: PubMed


To assess sperm morphology with Tygerberg (strict) and World Health Organization (WHO) 3rd criteria for intrauterine inseminations (IUI) between two eras to determine if there was a difference in pregnancy rates.
Retrospective study.
Academic institution.
127 couples with 290 IUI treatments during 1996-97 (era 1) and 133 couples with 317 IUI treatments during 2005-06 (era 2).
Pregnancy rates per cycle and couple.
Average sperm morphology was higher in era 1 than era 2 for both WHO 3rd (37 ± 13% vs. 23 ± 10%) and strict criteria (8.0 ± 5.0% vs. 4.0 ± 3.0%). Pregnancy rates per cycle were 5.9% versus 19.8% in era 1 and 16.7% versus 19.3% in era 2 for couples with WHO 3rd morphology <30% or ≥30%, respectively. Pregnancy rates per cycle were 2.7% versus 15.0% in era 1 and 13.3% versus 14.7% in era 2 for couples with strict morphology ≤4% or >4%, respectively.
There was a strong relationship between morphology and IUI outcome in era 1 that was not present in era 2. These results suggest that classification drift increased the percentage of men diagnosed with teratozoospermia and resulted in a loss of predictive value.

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Available from: C. C. Coddington, Jan 29, 2014
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