World J Mens Health.
2022 Jul;40(3):347-360. 10.5534/wjmh.210054.
Sperm Morphology Assessment in the Era of Intracytoplasmic Sperm Injection: Reliable Results Require Focus on Standardization, Quality Control, and Training
- Agarwal A
1 - Sharma R1
- Gupta S1
- Finelli R1
- Parekh N1
- Selvam MKP1,2
- Henkel R1,3,4,5
- Durairajanayagam D6
- Pompeu C7
- Madani S8
- Belo A9
- Singh N10
- Covarrubias S11
- Darbandi S12
- Sadeghi R11
- Darbandi M12
- Vogiatzi P13
- Boitrelle F14,15
- Simopoulou M16
- Saleh R17
- Arafa M1,18,19
- Majzoub A1,19
- Kandil H20
- Zini A21
- Ko E22
- Alvarez JG23
- Martinez M24
- Ramsay J25
- Jindal S26
- Busetto GM27
- Sallam H28
- Maldonado I29
- Anagnostopoulou C30
- Alves MG31
- Sengupta P32
- Gilany K33
- Evenson DP34
- Lewis SE35,36
- Gosalvez J37
- Ambar RF38
- Shah R39
- Affiliations
-
- 1American Center for Reproductive Medicine, Cleveland Clinic, Cleveland, OH, USA
- 2Department of Urology, Tulane University Health Sciences Center, New Orleans, LA, USA
- 3Department of Metabolism, Digestion and Reproduction, Imperial College London, London, UK
- 4Department of Medical Bioscience, University of the Western Cape, Bellville, South Africa
- 5LogixX Pharma, Theale, Reading, Berkshire, UK
- 6Department of Physiology, Faculty of Medicine, Universiti Teknologi MARA, Sungai Buloh Campus, Selangor, Malaysia
- 7Instituto Ideia Fèrtil, Santo Andrè, Brazil
- 8Department of Biology and Physiology of Organisms, Faculty of Biological Sciences, University of Science and Technnology, Houari Boumedien, Algiers, Algeria
- 9Huntington Centro de Medicina Reproditiva S/A, Sao Paulo, São Paulo, Brazil
- 10NOVA IVF, Gorakhpur, India
- 11Department of Physiology, University of San Francisco, CA, USA
- 12Fetal Health Research Center, Hope Generation Foundation, Tehran, Iran
- 13Andromed Health & Reproduction, Fertility Diagnostics Laboratory, Maroussi, Athens, Greece
- 14Reproductive Biology, Fertility Preservation, Andrology, CECOS, Poissy Hospital, Poissy, France
- 15Paris Saclay University, UVSQ, INRAE, BREED, Jouy-en-Josas, France
- 16Department of Experimental Physiology, School of Health Sciences, Faculty of Medicine, National and Kapodistrian University of Athens, Athens, Greece
- 17Department of Dermatology, Venereology and Andrology, Faculty of Medicine, Sohag University, Sohag, Egypt
- 18Department of Urology, Hamad Medical Corporation, Doha, Qatar
- 19Department of Urology, Weill Cornell Medicine-Qatar, Doha, Qatar
- 20Fakih IVF Fertility Center, Abu Dhabi, UAE
- 21Department of Surgery, McGill University, Montreal, QC, Canada
- 22Department of Urology, Loma Linda University Health, Loma Linda, CA, USA
- 23Centro ANDROGEN, La Coruña, Spain
- 24Section of Urology, University of Santo Tomas Hospital, Manila, Philippines
- 25Department of Andrology, Hammersmith Hospital, London, UK
- 26Department of Andrology and Reproductive Medicine, Jindal Hospital, Meerut, India
- 27Department of Urology and Renal Transplantation, University of Foggia Policlinico Riuniti of Foggia, Foggia, Italy
- 28Department of Obstetrics and Gynaecology, Alexandria University Faculty of Medicine, Alexandria, Egypt
- 29Citmer Reproductive Medicine, IVF LAB, Mexico City, Mexico
- 30IVF Clinic “Akeso-Embryo ART”, Athens, Greece
- 31Department of Anatomy, Unit for Multidisciplinary Research in Biomedicine (UMIB), Institute of Biomedical Sciences Abel Salazar (ICBAS), University of Porto, Porto, Portugal
- 32Department of Physiology, Faculty of Medicine, MAHSA University, Selangor, Malaysia
- 33Reproductive Biotechnology Research Center, Avicenna Research Institute, ACECR, Tehran, Iran
- 34SCSA Diagnostics, Brookings, SD, USA
- 35Queens University Belfast, Belfast, Northern Ireland, UK
- 36Examenlab Ltd., Weavers Court, Belfast, Northern Ireland, UK
- 37Genetic Unit, Department of Biology, Universidad Autónoma de Madrid, Madrid, Spain
- 38Department of Urology, Centro Universitario em Saude do ABC/Andrology Group at Ideia Fertil Institute of Human Reproduction, Santo André, Brazil
- 39Department of Urology, Lilavati Hospital and Research Centre, Mumbai, India
- KMID: 2530704
- DOI: http://doi.org/10.5534/wjmh.210054
Abstract
- Semen analysis is the first, and frequently, the only step in the evaluation of male fertility. Although the laboratory procedures are conducted according to the World Health Organization (WHO) guidelines, semen analysis and especially sperm morphology assessment is very difficult to standardize and obtain reproducible results. This is mainly due to the highly subjective nature of their evaluation. ICSI is the choice of treatment when sperm morphology is severely abnormal (teratozoospermic). Hence, the standardization of laboratory protocols for sperm morphology evaluation represents a fundamental step to ensure reliable, accurate and consistent laboratory results that avoid misdiagnoses and inadequate treatment of the infertile patient. This article aims to promote standardized laboratory procedures for an accurate evaluation of sperm morphology, including the establishment of quality control and quality assurance policies. Additionally, the clinical importance of sperm morphology results in assisted reproductive outcomes is discussed, along with the clinical management of teratozoospermic patients.
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