Morphological nuclear integrity of sperm cells is associated with preimplantation genetic aneuploidy screening cycle outcomes.

OBJECTIVE To examine the effect of sperm morphology on embryo development at the chromosomal level. DESIGN Prospective study. SETTING Assisted fertilization center. PATIENT(S) Couples who underwent IVF-PGS cycle, as a result of advanced maternal age, were randomly allocated into two groups: intracytoplasmic sperm injection (ICSI; n = 60) or intracytoplasmic morphologically selected sperm injection (IMSI; n = 60). INTERVENTION(S) IVF in conjunction with preimplantation genetic screening (PGS). MAIN OUTCOME MEASURE(S) Sperm nuclear morphology at high-magnification ICSI and incidence of aneuploidy in derived embryo. RESULT(S) There was a significantly increased incidence for sex chromosome aneuploidy in ICSI embryos when compared with IMSI embryos (23.5% vs. 15.0%, respectively). High-magnification sperm selection was associated with a significantly lower risk of sex chromosome abnormalities (odds ratio [OR], 0.57; confidence interval [CI], 0.37-0.90). The incidence of chaotic embryos was also significantly higher with the ICSI procedure (27.5% vs. 18.8%), while the IMSI procedure was associated with a significantly lower risk of chaotic embryos (OR, 0.64; CI, 0.43-0.96). Moreover, the cycle cancellation rate was significantly higher in ICSI cycles (11.8% vs. 2.5%). High-magnification sperm selection was a significant predictor of the likelihood of cycle cancellation (OR, 0.26; CI, 0.11-0.62). CONCLUSION(S) Spermatozoa free of nuclear morphological malformations were found to be significantly associated with the lower incidence of aneuploidy in derived embryos, resulting in lower rates of cycle cancellation.