Cover
Vol. 1 No. 1 (2011)

Published: June 30, 2011

Pages: 12-20

Research Article

Correlation between intra-uterine insemination outcome and Kruger strict criteria using two staining methods to detect the sperm morphology of infertile men

Abstract

Background: Since 1999 the World Health Organization (WHO) recommended the assessment of sperm morphology by Kruger strict criteria (KSC). The manual of WHO contains the cut off values of sperm morphology measured by KSC for normal subject and patients treated by in vitro fertilization (IVF) and intra- cytoplasmic sperm injection (ICSI) without any information regarding intrauterine insemination (IUI). Objectives: The objective of this study is to achieve two major goals that are:1- Assessment of sperm morphology by applying KSC, using two different biological stains, named commercially Testsimplets (TS)pre-stained slides and Sperm-O-Scan (SOS)stain 2- To have a cut off value for morphologically normal sperm that resulting into a successful IUI outcome. Materials and Methods: Fifty five unselected couples attending the Institute of Embryo Researches and Infertility Treatment were included in this prospective study from December 2007 till August 2008. The mean age of male partner was 31.7±1.87years with an average duration of 6.25±1.65years of infertility. The women were prepared for IUI. All the males were subjected to semen analysis with in vitro sperm activation using layering swim-up technique. Assessments of the morphologically normal sperm (MNS) of the samples were performed by using both, High power field and KSC by using TS and SOS stains before and after the activation. Correlation of the positive IUI results and MNS by KSC waw recorded denoting the cut off value for successful results. Results: The mean of morphologically normal sperm applying KSC with the use of SOS stain before in vitro sperm activation was 16.10% and after activation was 37.85% and by using TS stain before in vitro sperm activation was 15.14% and after activation was 37.09%. No significant (P>0.05) differences was detected between the results of MNS of the two stains. The result of IUI was 11 positive pregnancies out of the 55 cases. The mean of MNS using KSC for these positive cases was 11.58% and 12.84% for SOS and TS stains, respectively. Conclusions: The cut off value of MNS by applying KSC and using two different biological stains for a successful IUI program was 11.58% by SOS stain and 12.84% by TS pre-stained slides. Although the study found no statistical differences between the two stains, TS found to be easier, simpler and less time consuming technically than SOS stain.

References

  1. Jequier AM. Clinical andrology -still a major problem in the treatment of infertility. Hum. Reprod.2004, 19: 1245-1249.
  2. Liu DY and Baker HWG. Tests of human sperm functions and fertilization in Vitro. Fertil. Steril. 1992, 58: 465-483.
  3. Duran EH. Morshedi N. Tylor S and Oehninger S. Sperm DNA quality predicts intrauterine insemination outcome: a prospective cohort study. Hum. Repord. 2002, 17:3122-3128.
  4. World Health Organization. WHO laboratory manual for examining and processing of human semen 2010, 5th edition, Switzerland Press.
  5. KrugerTF, Menkveld R, Stander FS, Lombard CJ, VanDer Merwe JP and Van-Zyl JA, Smith K. Sperm morphologic features as a prognostic in in vitro fertilization. Fertil. Steril. 1986, 46: 1118-1123.
  6. Kruger TF, Acosta AA, Simmons KF, Swanson RJ, Matta JF and Oehninger, S. Predictive value of abnormal sperm morphology in in vitro fertilization. Fertil. Steril. 1988, 49: 112-116.
  7. Kruger TF, Acosta AA, Simmons K F, Sawsan Rj, Matta JF, Veek LI, Morshidi Mand Brugo S. New method of evaluating sperm morphology with predictive value for human in in vitro fertilization. Urol. 1987, 30 (3):248.
  8. World Health Organization. Reference values of semen variables. In: WHO laboratory manual for the examination of human semen and sperm-cervical mucus interaction. 4th ed. Cambridge University Press, Cambridge, UK. 1999, 4-33.
  9. Silverberg G and Turner T. Evaluation of sperm. In: Textbook of assisted reproductive techniques: laboratory and clinical perspectives. D.K., Gardener: A., Weissan, C.M. Howeles., Shonam (eds). Martin Duntiz, Ltd. 2001, 71-73
  10. Acosta AA, Uem JV, Ackorman SB, Mayer JF and Stecker J F. Estimation of male infertility by examination and testing of spermatozoa. In: In-vitro Fertilization. H. W. Jones; G. S. Jones; G. D. Hodjen, and Z. Rozenmarks, (eds),Williams and Wilkins. Baltimor.1986. Pp. 126-161.
  11. Cooke LD. Dewhurst's textbook of obstetrics and gynecology for Post-Graduates. D.K Edmonds(ed). Sixth edition. Blackwell Science Ltd, London 1999,437-442
  12. Sorlie DE. Medical biostatistics: Examination and board review. Norwalk. Connecticut. Appleton and lang.1995, Pp: 47-88.
  13. Bjorndahl L, Kirkman-Brown J, Hart G, Rattle S and Barrat CL. Development of a novel home sperm test. Human Reprod. 2006,1:145-149.
  14. Moreno RD, Santo JR, Edward KL, Wessel GM and Schatten J. The golgi apparatus segregates from the lysosomal / acrosomal vesicle during rhesus spermiogenesis: structural alteration. Develop. Bio. 2000, 219:334-349.
  15. Holt WV and Harrison RA. Bicarbonate stimulation of boar sperm motility via a protein kinase A-dependent pathway: between-cell and between ejaculate differences are not due to deficiencies in protein kinase A activation. J. Androl. 2002, 23(4):557-565.
  16. Morrell JM. Update on semen technologies for animal breeding. J.Reprod. Dom.Animal. 2006,41:63-67
  17. TersikJ. and Mendoza C. Gamete for assisted reproduction: past. present and future. J. Androl. 2003,24:321-328.
  18. Jose R, Carlo G, Posquale P, Sandro G, Teri O, Richardo H and Jose P. Intrauterine insemination and controlled ovarian hyperstimulation in cycles before GIFT. Hum. Reprod. 1989, 48:918-920.
  19. Madoro MR, Kirk CL, Chuang WW and Lamp DJ. Genes and male infertility: What can go wrong? J. Androl.2003, 24:765-789.