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

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 × 10(6), 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 × 10(6) ± 44.3 × 10(6)/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.