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Human Reproduction, Vol. 11, No. 7, pp. 1445-1450, 1996
© 1996 European Society of Human Reproduction and Embryology

research-article

Andrology: Semen parameters as predictors of in-vitro fertilization: the importance of strict criteria sperm morphology

Ahmed I. Vawda1,2, Joanne Gunby2 and Edward V. Younglai2

1Department of Zoology, University of Durban Westville Private Bag X54001, Durban 4000, South Africa 2Department of Obstetrics and Gynaecology, McMaster University Hamilton, Ontario, Canada L8N 3Z5

This study evaluated 120 couples undergoing in-vitro fertilization treatment to determine which semen parameter(s) predicted fertilization and whether there was any consistent relationship between strict criteria and standard assessment of sperm morphology. Strict criteria morphology was the only significant predictor of fertilization (P = 0.0006, r2 = 0.09), with a sensitivity of 94% and a specificity of 40%. A 12% cut-off point presented a negative predictive value of 98% and a positive predictive value of 22%. The probability of satisfactory fertilization is 40% with morphology <4%, which increases to 97% with normal morphology (≥12%). The receiver operating characteristic curve deviated significantly from the diagonal with a 76% area wider the curve, making this a superior predictive test. This was augmented by likelihood ratios (LR) of 8.25 (LR +) for results with <4% normal morphology and 0.15 (LR-) for results with ≥12% normal morphology by strict criteria. While there was some correlation between strict criteria and standard assessment of morphology (r2=0.35), the former explained only 12% (r2=0.12) of the variability in the latter. This study concludes that strict criteria morphology predicts fertilization, while other semen parameters do not. A 12% cut-off point makes strict criteria morphology an excellent predictor of satisfactory fertilization, while a value <4% is a good predictor of poor fertilization.

Key words: IVF/receiver operating characteristic curve/semen parameters/spermatozoa/sperm morphology


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