Impact of sperm morphology on the likelihood of pregnancy after intrauterine insemination

A strict sperm morphology of 4% is not associated with lower pregnancy rates compared with patients with a morphology of >4% who undergo intrauterine insemination.

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Nicolette E. Deveneau, M.D., Omar Sinno, M.D., Miriam Krause, M.D., Daniel Eastwood, M.S., Jay I. Sandlow, M.D., Paul Robb, M.D., Amy Granlund, B.A., Estil Y. Strawn Jr., M.D.

Volume 102, Issue 6, Pages 1584-1590



To determine whether there is a difference in ongoing pregnancy rates (PRs) between patients undergoing IUI with strict sperm morphology ≤4% compared with >4% on initial semen analysis.


Retrospective chart review with multivariate analysis.


Academic outpatient reproductive center.


A total of 408 couples with male and/or female factor infertility and known strict sperm morphology (SSM).


A total of 856 IUIs with partner’s sperm (IUI-P).

Main Outcome Measure(s):

Ongoing PRs based on ultrasound documentation of intrauterine pregnancy with fetal heart tones.


There is no statistically significant difference in per cycle PRs when comparing patients with a strict sperm morphology of ≤4% versus >4% who undergo IUI-P (17.3% vs. 16.7%; odds ratio 0.954, 95% confidence interval 0.66–1.37). Multiple potential confounding factors were assessed using multivariate analysis.


Strict sperm morphology ≤4% is not associated with lower PRs in couples undergoing IUI-P, and thus should not be the sole reason for advancing to IVF.

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Fertility and Sterility

Editorial Office, American Society for Reproductive Medicine

Fertility and Sterility® is an international journal for obstetricians, gynecologists, reproductive endocrinologists, urologists, basic scientists and others who treat and investigate problems of infertility and human reproductive disorders.