OBJECTIVETo compare the criteria of sperm morphology evaluation in the fifth edition of WHO Laboratory Manual for the Examination and Processing of Human Semen and those in the fourth edition, and to know the changes in the criteria of sperm morphology evaluation in the new edition.

METHODSNine technicians from Zhejiang Human Sperm Bank evaluated the morphology of 1 000 spermatozoa in 96 sperm morphological pictures according to the criteria in the fourth and fifth editions of WHO Laboratory Manual, respectively.

RESULTSThe percentage of morphologically normal sperm by the criteria of the fifth edition was (26.50 +/- 5.06)%, significantly higher than (11.39 +/- 3.17)% by the fourth edition (P < 0.05), while the rates of sperm head and tail defects based on the former were (64.26 +/- 7.66)% and (10.92 +/- 2.03)%, significantly lower than (76.11 +/- 8.18)% and (39.89 +/- 3.85)% according to the latter (P < 0.05). There were no significant differences in the rates of sperm midpiece defects and excessive residual cytoplasm by the fifth and fourth editions ([16.46 +/- 3.08]% vs [15.22 +/- 3.51 ]% and [4.24 +/- 1.66]% vs [3.87 +/- 1.68]%, P > 0.05).

CONCLUSIONThe criteria of sperm morphology evaluation in the fifth edition of WHO Laboratory Manual are less strict than those in the fourth, and the percentage of morphologically normal sperm is higher according to the fifth edition.

Humans ; Male ; Semen Analysis ; standards ; Sperm Head ; ultrastructure ; Sperm Midpiece ; ultrastructure ; Sperm Motility ; Spermatozoa ; ultrastructure ; World Health Organization

OBJECTIVETo evaluate the impact of sperm midpiece morphology observed under high-power microscope on embryo development following intracytoplasmic morphologically selected sperm injection.

METHODSMorphologically normal sperms from 57 patients undergoing intracytoplasmic sperm injection (ICSI) for male-factor infertility were selected microscopically (magnification of ×200 or 400) and subjected to motile sperm organellar morphology examination (MSOME) at high magnification of ×6000. According to the morphology of sperm medpiece, the sperms were divided into 3 groups, namely group A with a/b of 1-1.2, group B with a/b≥1.5, and group C with irregular morphology. The sperms in the 3 groups were intracytoplasmically injected in oocytes and the outcomes of the embryos were compared.

RESULTSGroups A, B, and C showed significant differences in the rate of ET-D3 top quality embryo (79.7% vs 55.6 % vs 33.3%) and implantation rate (43.2% vs 11.1% vs 0%), but not in the fertilization rate (73.3% vs 80.4% vs 63.5%), blastocyst formation rate (23.2% vs 22.2% vs 9.09%), cryopreservation rate (29.2% vs 25.0 % vs 13.0%), or D3 top quality embryo rate (35.3% vs 37.8% vs 18.8%).

CONCLUSIONSIn ICSI cycle, selecting morphologically normal sperms for intracytoplasic injection can increase the normal fertilization rate and top quality embryo rate on the transfer day and improve the implantation rate of the embryo.

Cryopreservation ; Embryo Implantation ; Embryonic Development ; Female ; Fertilization ; Humans ; Infertility, Male ; Male ; Oocytes ; Semen Analysis ; Sperm Injections, Intracytoplasmic ; Sperm Midpiece ; physiology