EFFECTIVENESS OF ASSISTED REPRODUCTIVE TREATMENT PROGRAMS DEPENDING ON THE CHARACTERISTICS OF SPERMOGRAM CHANGES

Introduction. There’re some pathological mechanisms of male fertility disorders that still don’t have proper diagnostic tests. This significantly decreases diagnostic value of a spermogram and makes the problem of evaluation of the characteristics of spermogram changes and their effects on the effectiveness of assisted reproductive technologies (ART) a pressing problem.

The study objective is to identify the correlation between effectiveness of ART programs and the characteristics of spermogram changes, in particular sperm concentration, motility, and morphology Materials and methods. At the V.I. Kulakov Research Center for Obstetrics, Gynecology and Perinatology in the period from December of 2012 to December of 2016, 10,042 married couples who underwent treatment using ART (2221 – in vitro insemination (IVF), 7821 – IVF with intracytoplasmic sperm injection) were examined.

Results. In patients after IVF, the frequency of live births significantly depended on sperm concentration: 28.6 % for concentration above 5 mil/ml and 51.5 % for concentration above 15 mil/ml (p <0.0001). No significant difference was observed for the dependence of the frequency of live births on the number of progressive-motile sperm (grade А): 38.2 % for <5 % and 57.7 % for >15 % (p = 0.11), or on the number of spermatozoa with normal morphology: 50 % for ≥4 % and 45.5 % for <4 % (p = 0,23). In patients after IVF with intracytoplasmic sperm injection, the concentration of spermatozoa, number of progressive-motile sperm (grade А), and number of spermatozoa with normal morphology didn’t affect the frequency of live births in a statistically significant way.

Conclusion. Sperm concentration, motility, and morphology can affect the frequency of live births in the IVF program, but statistically significant correlation was observed only for sperm concentration. After IVF with intracytoplasmic sperm injection, only sperm morphology affects the frequency of live births, but not in a statistically significant way. 

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