Human Reproduction, Vol. 18, No. 8, 1643-1649,
August 2003
© 2003 European Society of Human Reproduction and Embryology
Automated semen analysis: ‘zona pellucida preferred’ sperm morphometry and straight-line velocity are related to pregnancy rate in subfertile couples
University of Melbourne Departments of 1 Obstetrics and Gynaecology, and Reproductive Services and 2 Andrology, Royal Women’s Hospital, 132 Grattan Street, Carlton, 3053 Australia, and 3 Melbourne IVF, 320 Victoria Parade, East Melbourne, 3002 Australia
4 To whom correspondence should be addressed. e-mail: garrettc{at}unimelb.edu.au
BACKGROUND: Standard semen analysis has low objectivity and reproducibility and is not closely related to fertility. We assess the prognostic value of automated measurements of sperm motility and morphology. METHODS: During 1997–1999, 1191 infertile couples with no known absolute barrier to conception were assessed by conventional semen analysis, and automated measurements of average straight-line velocity (VSL) and the percentage of sperm with characteristics that conform to those of sperm which bind to the zona pellucida of the human oocyte (%Z). During follow-up to 2001, there were 336 natural pregnancies. RESULTS: Only %Z, VSL and female age were independently significantly related to pregnancy rate by Cox regression analysis. Pregnancy rate was higher with above average %Z and VSL, indicating a continuous rather than a threshold relationship. The likelihood of pregnancy within 12 cycles can be evaluated for specific values of %Z, VSL and female age using the Cox regression model. CONCLUSIONS: The automated semen measures of sperm morphometry (%Z) and velocity (VSL) are related to pregnancy rates in subfertile couples and should assist clinicians in counselling subfertile patients about their prognosis for a natural pregnancy. Objective automated methods should replace the traditional manual assessments of semen quality.
Key words: automated semen analysis/male infertility/pregnancy rate prediction/sperm morphometry/sperm velocity
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