Factors influencing clinical pregnancy outcome of in vitro fertilization/intracytoplasmic sperm injection in older women

Correlation analysis of a novel artificial intelligence optical microscope-assisted semen assessment system with IVF outcomes

PURPOSE

On the day of fresh oocyte retrieval in in vitro fertilization (IVF) cycles, a novel portable artificial intelligence optical microscope (AIOM) was employed to assist in the assessment of semen parameters. This study analyzed the correlation between sperm kinetic and morphological parameters with short-term IVF outcomes. Additionally, it explored whether these parameters could serve as predictive indicators for rescue intracytoplasmic sperm injection (R-ICSI) in IVF patients.

METHODS

A retrospective analysis was conducted on patients undergoing short-term IVF at the West China Second Hospital of Sichuan University between May 2021 and May 2024. Based on fertilization outcomes, the short-term IVF patients were categorized into a successful fertilization group (group A, n = 281) and a group requiring R-ICSI after failed fertilization (group B, n = 49). AIOM was utilized to analyze semen parameters including pH, sperm concentration, sperm motility parameters, sperm movement trajectory parameters, and sperm morphological parameters. The study further investigated the correlation between these short-term IVF fertilization-related laboratory indicators and IVF outcomes.

RESULTS

No statistically significant difference was observed in semen pH between the two groups. However, there were significant differences in sperm concentration and the majority of motility parameters. Specifically, compared to group A, patients in group B exhibited lower sperm concentration (p = 0.01), motility (p = 0.01), local motility (p = 0.01), progressive motility (PR) (p = 0.00), total motility (p = 0.01), and amplitude of lateral head displacement (ALH) (p < 0.01), along with higher immotility (p = 0.00). No statistically significant differences were found between the two groups in other sperm motility, velocity, or trajectory parameters. Additionally, sperm morphological parameters were also associated with short-term IVF fertilization outcomes. Compared to group A, group B had higher sperm head length mean (p < 0.01), head perimeter mean (p < 0.01), and head area mean (p = 0.01), as well as lower tail length mean (p = 0.01). Multivariate regression analysis of fertilization outcomes indicated that higher immotility (p = 0.01) and head length mean (p < 0.01), along with lower tail length mean (p = 0.04), were independent risk factors affecting successful short-term IVF fertilization. Notably, head length mean showed a significant negative correlation with polyspermy rate (p < 0.01), whereas tail length mean was significantly positively correlated with polyspermy rate (p < 0.01).

CONCLUSION

Optimization of semen parameters with AIOM at the time of fertilization is significantly associated with short-term IVF fertilization outcomes. Abnormal semen parameters at fertilization-specifically, higher immotility and head length mean, along with lower tail length mean-can be considered risk factors for fertilization failure and may serve as predictive indicators for potential R-ICSI.

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