Assessing the impact of semen quality on embryo development in an egg donation model

• Main Authors: Lusine Aghajanova, M.D., Ph.D., Chia-Ning Kao, M.S., Marcelle Cedars, M.D., Nam Tran, M.D., Ph.D.
• Format: Article
• Language: English
• Published: Elsevier 2021-03-01
• Series: F&S Reports
• Subjects: Semen quality; embryo development; blastocyst; pregnancy outcome; male age; total motile count
• Online Access: http://www.sciencedirect.com/science/article/pii/S2666334120300994

Objective: To investigate if any of the World Health Organization semen parameters and/or male age are associated with embryo development. Design: Retrospective chart review between January 2008 and May 2015. Setting: Academic fertility practice. Patients: Anonymous egg donors aged ≤30 years. Interventions: Chart review. Main Outcome Measures: Sperm parameters were evaluated on a continuum and were dichotomized to determine if low values (strict morphology < 4%, concentration < 15 × 106, low motility < 40%) or older age (>50 years) are associated with embryo morphology. Repeated linear regression measures to determine the associations and multivariate testing to determine independent effects for each predictor were performed. Results: Three hundred eighty-four donors with 574 egg donation cycles were identified, and 205 subjects with 275 cycles were included in the final analysis. The mean donor age was 25.31 ± 2.81 years, with a mean antral follicle count of 28.09 ± 10.5. The mean male age was 43.25 ± 6.65 years. The mean World Health Organization semen parameters at fertilization were 55.8 × 106 ± 44.3 × 106/mL concentration, 44.8% ± 20.2% motility, and 6.9% ± 5.3% strict morphology. Neither male age nor sperm morphology was associated with embryo morphology. A low total motile count was significantly associated with a higher cell number in day-3 embryos and a 1.56-times higher chance of poor day-3 cell symmetry. There was no statistically significant difference in blastocyst formation, clinical pregnancy, or live-birth rates. Conclusions: Although statistically significant, the effect of the low total motile count on day-3 cell number and cell symmetry are likely clinically insignificant. Male age, race, or poor sperm morphology were not associated with a poor cycle outcome or impaired embryo development. The use of intracytoplasmic sperm injection likely alleviates the negative effect of diminished semen quality on treatment outcome.