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The Influence of Sperm Concentration in the Ejaculate Used for ICSI on the Outcome of the ART Cycle

Friedler S, Cohen O, Liberty G, Saar-Ryss B, Latzer T and Meltzer S

The sperm concentration in the ejaculate might be a crucial factor predicting the success of the ICSI procedure. Data in the literature is controversial and not recent in spite of many technical improvements added to the ART laboratory. To examine the influence of sperm concentration in the ejaculate used in the laboratory on the live-birth rate following ICSI and embryo transfer we conducted a retrospective study on all patients that were treated at our IVF unit during the period of January 2011 and July 2014. A total of 1145 ICSI cycles were divided into four groups according to the ejaculated sperm concentration (millions/ml) on the day of oocyte retrieval: group I: <1 (254 cycles); group II: 1-5 (89 cycles); group III: 5-9 (110 cycles); group IV: 10 or more (692 cycles). Groups I-III were the study groups and group IV served as the control. The demographic background, parameters of the ovarian response and parameters of the laboratory and clinical outcomes were compared between the four groups including 2PN fertilization rate; embryo implantation rate (IR); clinical pregnancy rate (CPR) and live birth rate (LBR) per cycle initiated and per embryo transfer (ET). Comparing the four groups of sperm concentration, ICSI in group 1 resulted in significantly decreased 2-PN fertilization rate (56.3 ± 25.7, 58.4 ± 25.2, 63.3 ± 28.7, 63.3 ± 30.7 for groups I, II, III, IV respectively, p=0.006). However, live-birth rates (23.2, 24.7, 23.6, 24.0, for groups I, II, III, IV respectively, p=0.35) as well as all the other clinical parameters examined were comparable between the groups. Logistic regression stepwise analysis, found that sperm concentration had no predictive value for live-birth achievement.