Impact of spermatogenesis parameters on effectiveness of assisted reproductive technology programs: single-center retrospective study

INTRODUCTION. Spermogram parameters such as sperm concentration, motility and morphology are used to evaluate the intensity of spermatogenesis, as well as some stages of the embryological stage of assisted reproductive technology (ART) programs: fertilization and embryo fragmentation. However, the prognostic value of the standard spermiologic study for ART outcomes remains controversial.

OBJECTIVE. To evaluate the effect of sperm concentration, motility and morphology on the onset of clinical pregnancy, incidence of unintended pregnancy and live birth in patients who have undergone ART procedures.

MATERIALS AND METHODS. A single-center retrospective study involved 557 couples treated by in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI). Depending on the results of spermograms, 4 groups were formed: patients with normozoospermia (n = 139), asthenozoospermia (n = 126), teratozoospermia (n = 149) and oligo-, oligoasthenoteratozoospermia (n = 143). Descriptive statistics, chi-square test and logistic regression were used to assess outcomes.

RESULTS. Clinical pregnancy rate in in the group with normozoospermia was 37,4 %, which is significantly higher than in the group with asthenozoospermia (23,0 %), teratozoospermia (24,2 %) and comorbidity (21,7 %) (p = 0,010). Live birth rate was highest in the group with normozoospermia – 32,4 %, compared to 15,9 % with asthenozoospermia and 16,8 % with comorbidity (p = 0,003). Logistic regression analysis has showed that increasing sperm motility raises probability of live birth 1,010 times (p = 0,033). However, the model has explained only 1,3% of variance in outcomes, indicating its low predictive power.

DISCUSSION. The study results show that pathozoospermia is associated with reduced likelihood of pregnancy and live birth in ART programs, which is consistent with other studies. However, the association of spermogram parameters with the effectiveness of ART is not confirmed in all studies, indicating that additional factors, such as sperm DNA fragmentation, need to be taken into account. In addition, differences in outcomes may be related to equipment and approaches to ART procedures.

CONCLUSION. Simple spermogram parameters, such as sperm concentration, motility and morphology, can predict the outcome of ART, including the rate of clinical pregnancy and live birth, However, their prognostic value remains limited, requiring further research to develop more accurate prediction models.

marine medicine, spermogram, sperm motility, in vitro fertilization, intracytoplasmic sperm injection, clinical pregnancy, live birth, assisted reproductive technologies

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