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Int J Mol Epidemiol Genet 2012;3(3):205-212

Original Article
Embryo quality and implantation rates are not influenced by total motile count
values in an ICSI programme: a novel point of view

Anat Hershko-Klement, Einav Rovner, Daniel Yekutieli, Yehudith Ghetler, Ofer Gonen, Ilan Cohen, Amir Wiser, Arie Berkovitz,
Adrian Shulman

Department of Obstetrics and Gynecology, Meir Medical Center, Kfar Saba, Israel; Department of Statistics and Operations
Research, School of Mathematical Sciences, Tel Aviv University, Tel Aviv 69978, Israel

Received April 24, 2012; accepted August 5, 2012; Epub August 31, 2012; Published September 15, 2012

Abstract: Total motile count (TMC) is a useful tool for sperm evaluation, comprising both quantitative and motility parameters.
Although frequently used, TMC has not yet been evaluated as a contributory variable for intracytoplasmic sperm injection (ICSI)
cycles. In this study we evaluate the possible role of TMC as a prognostic parameter in cycles designated for ICSI. We also test
the existence of a possible TMC-threshold value that might be predictive for ICSI cycle outcome in the everyday practice. This is
a retrospective cohort study in which the research question is addressed by a locally weighted regression (LOESS) analysis.
Primary outcome measures are fertilization rate, good quality embryos rate and implantation rate. A total of 666 patients were
included, contributing 1456 cycles. The effect of TMC over the fertilization rate was significant, depicting an inverted U-shaped
curve: with up to approximately 10 million motile sperm, fertilization rates increased as TMC increased, but from this point on
decreased. A slight increment in the rate of good embryo formation with increasing value of TMC was noted, but this did not
reach a statistical significance. TMC values demonstrated no effect in the case of implantation rates. ICSI may offer an
advantage related to fertilization rates for the sub-fertile male population, with a motile sperm count up to 10 million.

Keywords: Male infertility, sperm motility, ICSI, fertilization, embryo Implantation

Address all correspondence to:
Dr. Anat Hershko- Klement
Department of Obstetrics and Gynecology
Meir Medical Center
59 Tschernichovsky St.
Kfar Saba 44281, Israel.
Tel: 972-9-7472227; Fax:972-9-7472645
E-mail: anat.hershko@clalit.org.il  Or: anat.klement@gmail.com