Who vs strict sperm morphology test
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Sperm Morphology (Shape): Does It Affect Fertility?
The debate and few of sperm may end male craft. Selectivity of the united sperm-zona pellucida binding trace to sperm myth morphometry.
Once the sperm enters the egg, fertilization has a good chance of taking place. If an abnormally shaped sperm can fertilize an egg, why does the shape matter? No one is sure why the sperm shape matters. Men with abnormally shaped sperm tend to have more trouble causing a pregnancy, but we cannot say for sure whether that difficulty is caused by the shape of the sperm itself or by another reason that causes the sperm to be shaped differently and at the same time causes a problem with fertility. Is there anything I can do to improve the shape of my sperm? Research has not shown a clear relationship between abnormal sperm shape and tobacco, alcohol, or caffeine use, though some studies suggest that smoking can impair fertility.
While you are trying for a pregnancy, you should not use tobacco or recreational drugs and you should limit your consumption of alcohol. These substances may hurt sperm DNA material that carries your genes quality. Studies have not shown a clear connection between caffeine consumption and changes in sperm shape. Remember that it may take up to 3 months for any changes to your sperm to become noticeable. However, we have found that despite trying to address this issue with non-fertility specialists, they continue to be overly concerned by such results and convey this concern to their patients.
However, there is insufficient data to show that it predicts efficacy in patients not undergoing IVF Furthermore, with the increasing use of PGS and the prevalence of the diagnoses of unexplained and male factor infertility, many fertility programs are preferentially, if not exclusively, using ICSI in their IVF cycles. To further explore this issue, we looked at the last couples going through IVF at our institution.
Anytime certain methods of people can be downloaded objectively Implements usually assess sperm mi during a careful semen analysis or significant test. Concerns are classified into three groups Figure 5:.
However, the median motility in the presumed non male factor group was below the normal value. This may indeed be the case, though no further evidence has arisen which points to an additional clinical use for sperm morphology. Given all the morpholkgy discussed above, many fertility specialists tend to dismiss the morphologic assessments reported on semen analyses or at least feel it is of limited clinical value. The American Urological Association mogphology issued a statement that sperm morphology by the strict criteria has Wbo been shown to be consistently predictive of fecundity and should not be used in isolation to make prognostic or therapeutic decisions.
World Health Organization reference values for human semen characteristics. Hum Reprod Update ;16 3: Continued existence of significant disparities in the technical practices of sperm morphology assessment and the clinical implications: Sperm morphology is determined using brightfield illumination at x magnification, after preparing air-dried Papanicolaou-stained smears. All slides were read blind by an experienced highly trained technician who produced consistent and reliable results. No dimensions and no description of a normal midpiece are mentioned. Defects are described, e. No dimensions and no description of a normal tail are mentioned, only defects are described. Using this classification scheme, all borderline forms are considered abnormal.
Head defects are: Neck or midpiece defects are: Tail deffects include short, multiple hairpin, broken, irregular width or coiled tails, tails with terminal droplets or any combination of these. A minimum of spermatozoa is counted and a stage micrometer is used to aid interpretation. The teratozoospermia index is a measure of the average number of defects per spermatozoa, which could be used to improve the correlation between sperm morphology and fertility. Basic semen evaluation is performed after liquefaction of the specimen. Two morphology slides are prepared for each patient and are stained by the quick-stain technique Diff-Quick solution 1 and 2.
The slides are reported on the same day. The morphology is evaluated by two independent observers. Strict criteria of sperm morphology established by Kruger et al. No abnormalities of the neck, midpiece or tail and no cytoplasmic droplets of more than half of the sperm head are accepted. Borderline forms are considered abnormal. The amorphous-head group is divided into two categories: Neck defects are also classified in two categories: All other abnormal sperm forms- round, small, large, tapered, double head, double or coiled tail, cytoplasmic droplets-are classified following the WHO classification.
At least cells per slide are to be evaluated.
A strjct in the eyepiece of the microscope is used for routine measurements. These spermatozoa are usually in an apparently homogenous population Figure 3. The morphological classification used tet Menkveld is based on a modification of the methods of Mac Leod and Gold and Eliasson The head must have a smooth morphologyy configuration with a well-defined acrosome comprising approx. The range of variation within the normal stgict is shown in Figure 4. Neck, midpiece or tail defects are considered abnormal. These are strict criteria. Spermatozoa are classified into seven groups Figure 5: At least but preferably spermatozoa are evaluated. Inexperienced workers should use a built-in micrometer when they begin with morphology evaluations.
The normal dimensions for spermatozoa stained with the Diff-Quik method used by Kruger are larger than those based on the Papanicolaou method. In order to improve the evaluation of sperm morphologyDavis and Gravance have emphasized the sensitivity of sperm classification methods when only two morphometric variables are used lenght and width of the head, for example. Based on linear models as an appropriate mean of describing the size relationship between phenotypic characters, they show that small changes can significantly alter the percentage of normal sperm within a specimen.
A new expression of sperm morphology parameters is the sperm deformity index SDIdescribed in 2.
Sperm test morphology vs Who strict
This is a method by where the whole spermatozoon is assessed by the strict criteria and classified more than once if more than one deformity exists. Both normal and abnormal sperms are considered and the average number of deformities per sperm is determined to give a value to this index. This index reflects the balance between the prevalence of sperms with multiple vss deformities and the proportion of sperms with normal morphology in a strcit sample. Computer-assisted methods of sperm sprm evaluation Over Who vs strict sperm morphology test Whl 20 years, in order to avoid subjectivity, numerous studies that incorporate image analysis techniques in the assessment of sperm morphology have appeared.
The method of Moruzzi for quantification and classification of human sperm morphology by computer-assisted image analysis is semi-automated Measurements included stain content, lenght, width, perimeter, area, and arithmetically derived combination. Additionally, each sperm image is optically sectioned at right angles to its major axis, to give a measure of lenghtwise heterogeneity of shape. According to this method, the strift of normal sperm heads can be accurately predicted using just four sperm head measurements. The system described by Perez-Sanchez is based on the evaluation with a video digitizer board, a brightfield microscope with a x immersion objective, two monitors and the image analysis software 31 Figure 6.
Cells are displayed live on the video monitor and each sperm head image is processed automatically using a specific image analysis program for image enhancement and thresholding. Analysis of the sperm midpiece and tail is not included in the program. The system detects the boundary of the sperm head and the outline is displayed as white overlays superimposed on the video image. The set of morphometric parameters used by Perez constitutes a set of characteristics which is valid for characterization of the majority of morphological types of spermatozoa.
Conclusions The association between semen quality and male infertility has been known for more than 40 years. Having reviewed the literature, it seems clear that strict morphology has a clinical relevance, being an excellent biomarker of sperm fertilizing capacity, in vivo and in vitro, independent of motility and concentration Sperm morphology evaluation is considered to be a highly subjective procedure because, unlike the haematopoietic cells for example, the difficulty in classifying human sperm morphology is caused by the large variety of abnormal forms found in the semen of infertile and fertile men. Only certain types of abnormality can be quantitated objectively Normal sperm morphology needs to consider two points.
The first one is the proportion of spermatozoa with normal morphology in semen and the second is the definition and the characterization of the normal spermatozoa. The sperm deformity index is a more reliable predictor of the outcome of fertilization in vitro than the proportion of normal sperm morphology. WHO recommends that each laboratory recruits fertile men a reference population in order to investigate and determine the real cut-off values for normality in that laboratory These men are very difficult to recruit, therefore only a few laboratories actually perform this analysis 3. During the past 15 years there has been an increase in total motile sperm count, secondary to an increase in semen volume, and a decline in normal morphology.