Impact of individual sperm morphology on intracytoplasmic sperm injection in a selected hospital of Bangladesh: A retrospective analysis

The development of an embryo necessitates the involvement of both male and female gametes. Nevertheless, the fertilization process can be impeded by abnormal sperm development, resulting in infertility. Intracytoplasmic sperm injection (ICSI) was devised to address these male fertility issues. The aim of this study is to assess the effect of sperm morphology on fertilization, embryonic development, and pregnancy outcome. Data collection and follow-up were conducted on individuals who had recently undergone semen morphology assessment and ICSI, with participants recruited according to specific inclusion and exclusion criteria. After signing consent forms and receiving an explanation of the project, participants’ results were categorized, tabulated, and subjected to statistical analysis using SPSS V26 (2019). Patients were grouped by sperm morphology, as determined by WHO staining techniques, and compared in terms of fertilization and cleavage rates using unpaired T-tests, while pregnancy outcomes were calculated as percentages. Additionally, a chi-square test was employed to explore potential relationships between sperm morphology and fertilization rate, pregnancy rate, and cleavage rate. Findings were documented for the thesis, with a significance level set at alpha = 0.05. This study of 100 ICSI participants found that, while fertilization (8.5 vs. 7.7) and cleavage rates (6.05 vs. 6.3) were similar between normal and abnormal sperm morphology groups, normal morphology significantly improved pregnancy rates (51.3% vs. 13.6%, p=0.002). With major infertility causes including tubal factors (20%) and PCOS (18%), the findings underscore the potential of advanced selection techniques like IMSI to enhance outcomes by leveraging sperm morphology as a predictor of ICSI success. The study concludes that normal sperm morphology significantly boosts pregnancy outcomes in ICSI, underscoring the potential of advanced selection methods like IMSI to improve success rates for couples with infertility challenges.