Melis, Mario (2009) Esame del liquido seminale: valutazione della morfologia secondo lo "strict metod". Doctoral Thesis.
The World Health Organization in 1980 first published a laboratory manual for the examination of human semen and sperm-cervical mucus interaction in response to a growing need for the standardization of examination of human semen. As the field of andrology advanced, so the manual has been revised. The last (fourth) edition has been released in 1999 and it recommends the so called "strict criteria" to classify sperm morphology. This method allows a simplified classification of morphology that seems to correlate with clinical findings in assisted reproduction. This findings have been disputed indeed but till now we haven’t, in our opinion, a better way to define sperm morphology. Despite this, the majority of labs are unable to follow these criteria. To define the role of morphology in male fertility could lead to a better use of assisted reproduction suggesting less invasive and expensive methods in some cases while allowing a direct passage to micromanipulation in other couples where evidence-based data show very low possibility of pregnancy passing through other ways. The present study retrospectively compares sperm morphology with fertilization rate (FR) and pregnancy rate (PR) in two groups of couples submitted in a conventional IVF protocol. Our results seem to confirm the better FR and especially PR (31 vs 3,6%) where normal sperm morphology was >14% using strict criteria. We hope there will be a prospective and larger cooperative study amongst many IVF centers to better define sperm characteristics involved in male fertility.
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