ABSTRACT
Sperm morphology was once believed as one of the most predictive indicators of pregnancy outcome in assisted reproductive technology (ART). However, the impact of teratozoospermia on in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI) outcomes and its offspring remains inconclusive. In order to evaluate the influence of teratozoospermia on pregnancy outcome and newborn status after IVF and ICSI, a retrospective study was conducted. This was a matched case-control study that included 2202 IVF cycles and 2574 ICSI cycles and was conducted at the Reproductive and Genetic Hospital of CITIC-Xiangya in Changsha, China, from June 2013 to June 2018. Patients were divided into two groups based on sperm morphology: teratozoospermia and normal sperm group. The pregnancy outcome and newborn outcome were analyzed. The results indicated that couples with teratozoospermia had a significantly lower optimal embryo rate compared to those with normal sperm morphology in IVF (P = 0.007), while there were no statistically significant differences between the two groups in terms of the fertilization rate, cleavage rate, implantation rate, and pregnancy rate (all P > 0.05). Additionally, teratozoospermia was associated with lower infant birth weight in multiple births after IVF. With regard to ICSI, there was no significant difference in both pregnancy outcome and newborn outcome between the teratozoospermia and normal groups (both P > 0.05). Furthermore, no increase in the risk of birth defects occurred in the teratozoospermia group after IVF/ICSI. Consequently, we believe that teratozoospermia has limited predictive value for pregnancy outcomes in IVF/ICSI, and has little impact on the resulting offspring if multiple pregnancy is avoided.
ABSTRACT
<p><b>OBJECTIVE</b>To investigate the major cardiovascular risk factors affecting small arterial elasticity and the effect of combined multiple risk factors on it.</p><p><b>METHODS</b>Arterial elasticity indexes (C(1)-large artery and C(2)-small artery) were measured with CVProfilor DO-2020. The status of insulin resistance was evaluated with HOMA (homeostasis model assessment). Subjects were categorized into abnormal C(2) group and control group according to the level of C(2). The former group was further divided into four subgroups (0 to 3) based on the number of risk factors.</p><p><b>RESULTS</b>(1) The levels of age, total cholesterol (TC), low density lipoprotein- cholesterol (LDL-C), fasting blood glucose (FBG), systolic blood pressure (SBP) and diastolic blood pressure (DBP) in abnormal C(2) group were higher than those in control group, whereas C(2) itself was lower than that in control group (P all < 0.05). Age, TC, LDL-C, FBG, SBP and DBP were significantly inversely correlated with C(2). (2) With the clusters of risk factors increasing, C(2) was decreasing (6.5 +/- 2.6 vs 5.4 +/- 2.3 vs 4.7 +/- 2.7 vs 3.1 +/- 1.6, P < 0.001). C(2) decreased significantly in subjects with multiple risk factors (subgroup 3). (3) Fasting plasma insulin and HOMA-IR (insulin resistance index) were significantly higher in subgroup 3 than in the other subgroups (P < 0.05, P < 0.001 respectively).</p><p><b>CONCLUSIONS</b>The elevations of age, TC, LDL-C, FBG, SBP and DBP were the major cardiovascular risk factors on the reduction of C(2), and the effects on it were continuously. With their concurrent effects, multiple risk factors could decrease small arterial elasticity much more significantly. Insulin resistance seems to be closely related to the clusters of multiple risk factors.</p>