Sperm count affects cumulative birth rate of assisted reproduction cycles in relation to ovarian response



To explore the possible influence of sperm quality, as assessed by prewash total sperm count (TSC), on cumulative success rates in assisted reproduction cycles.


Retrospective study carried out in private IVF centre. Seven hundred sixty-five couples undergoing complete ICSI cycles, i.e. whose all embryos were transferred or disposed of. Couples were characterised by male infertility and female age younger than 36 years. Couples with a combination of female and male infertility factors were excluded. The primary outcome measure was cumulative live birth rate. Secondary outcomes were cumulative pregnancy and miscarriage rates. No specific interventions were made.


Higher TSC values have a positive impact on cumulative success rates in cycles characterised by few retrieved oocytes (1 to 5), while does not influence the outcome of cycles with a normal (6 to 10) or high (> 10) number of retrieved oocytes.


The study highlights the importance of sperm quality for the efficacy of assisted reproduction treatments. This influence may remain relatively cryptic in association with normal or high ovarian response, but emerge decisively in cases of reduced ovarian response, suggesting a relationship between ovarian response and oocyte ability to compensate for paternal-derived deficiencies.

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The study was self-funded by 9.baby - Family and Fertility Center.

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Correspondence to Giovanni Coticchio.

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Approval for the study was obtained from the local Institutional Review Board. Informed consent was obtained from selected patients.

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Supplementary Table 1 Post hoc analysis among groups on CPR, miscarriage rate and CLBR Supplementary Table 2 Outcome rates of cycles classified according to TSC and subanalysed based on number of retrieved oocytes. a: P < 0.0001, b: P = 0.0085, c: P = 0.0045, d: P = 0.012, e: P = 0.0019, f: P = 0.0121 (DOCX 21.4 kb)

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Zacà, C., Coticchio, G., Tarozzi, N. et al. Sperm count affects cumulative birth rate of assisted reproduction cycles in relation to ovarian response. J Assist Reprod Genet 37, 1653–1659 (2020). https://doi.org/10.1007/s10815-020-01807-5

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  • Sperm count
  • Ovarian stimulation
  • Assisted reproduction
  • Pregnancy
  • Live birth