How does sperm quality affect IVF success?
A semen analysis is a rudimentary test of a man’s sperm count. Men with low sperm counts (less than 5 million motile sperm) will likely have difficulties achieving pregnancies. Any man with more than one abnormal defect in his semen analysis will also have a difficult prognosis. Morphology is an interesting area as many men will have isolated abnormal morphology. Some of these men will have difficulty fertilizing eggs but not all. This makes it difficult to counsel these patients and often we turn to IVF with ICSI (intra cytoplasmic sperm injection) to assist these couples in conceiving. The use of antioxidants is one therapy which has shown to be effective in some men with borderline morphology, although typically 3-6 months of therapy is needed to show just a small improvement in morphology.
There are a group of Sperm DNA fragmentation tests on the horizon such as Tunnel, Comet and SCSA Assays. The contribution of sperm DNA to embryo quality is an important area of research however the reproducibility and reliability of these tests are still being investigate.
Finally, if a high sperm DNA fragmentation index is found, the only options are antioxidant vitamin therapy or use of donor sperm. The jury is still out on the utility of these tests. For most couples with male factor infertility, IVF with ICSI has been used to help overcome many of these deficiencies successfully. Couples should discuss their specific case with their Reproductive Specialist or seek out a reproductive urologist for further testing.
-Blog Post by Dr. Thomas Molinaro, MD, MSCE, FACOG
Physician Partner, Reproductive Medicine Associates of New Jersey Eatontown, NJ