A PROSPECTIVE-STUDY ON THE PREDICTIVE VALUE OF NORMAL SPERM MORPHOLOGY AS EVALUATED BY COMPUTER (IVOS)

Objective: To evaluate the IVOS (Hamilton Thorne Research Version 2.1 Dimension Program, Beverly, MA) system's ability to predict fertilizat ion in vitro in a prospective study. Design: A prospective clinical st udy. Setting: Hospital-based academic ART program. Patients: Eighty pa tients from the IVF-GIFT program were evaluated. The same semen sample was analyzed on a day-to-day basis by both laboratory (manual method) and the computerized system for percentage normal morphology, concent ration/mL, motility, and forward progression. Only patients with two o r more metaphase II (MII) oocytes available were allowed into the stud y and excluded where the male partner had antisperm antibodies or qual ified for intracytoplasmic sperm injection (< 500,000 motile spermatoz oa obtained after glass wool separation). Statistical Analysis: Logist ic regression analysis was used to study predictors of fertilization i n vitro. Results: Three hundred thirty-eight oocytes were obtained fro m 80 patients of which 239 fertilized. The logistic regression analysi s of the manual method (percentage normal morphology) and IVOS indicat ed that both were predictors of fertilization. Sperm morphology as eva luated by IVOS in patients with < 10 x 10(6) motile spermatozoa/mL ret rieved after swim-up was a significant predictor of fertilization as w as the number of oocytes obtained. Thus, the more oocytes obtained in the lower morphological groups, the better the chance of fertilization . The fertilization rate in the morphology group 0% to 4% normal forms was 45.6% (37/81) and in the group > 14% normal forms was 85.2% (69/8 1). Conclusions: It was shown that in patients where less than or equa l to 10 x 10(6) motile spermatozoa were obtained, the role of morpholo gy (evaluated by IVOS) as well as the number of oocytes were important predictors of fertilization. The computer can assist to identify thes e patient with a poor prognosis for fertilization.