The relationship between sperm parameters and fertilizing capacity in vitro: a predictive role for swim-up migration.

The relationship between sperm parameters and fertilizing capacity in vitro was examined retrospectively, with the aim of finding predictive criteria for successful in vitro fertilization. Three hundred thirty semen samples were used to inseminate 1462 oocytes. Conventional parameters of sperm concentration and percentage motility in the ejaculate as well as swim-up migration were analyzed in relation to fertilization rate. It was shown that the probability of fertilizing human oocytes in vitro decreases significantly when (a) the sperm concentration is below 20 x 10(6) spermatozoa/ml ejaculate (P = 0.006), (b) motility is lower than 80% (P = 0.002), or (c) less than 4 x 10(6) motile spermatozoa/ml are concentrated in the swim-up fraction (P less than 0.0001). It was also demonstrated that nonfertilizing sperm could not be distinguished from fertilizing sperm by the conventional criteria but rather by the average concentration of motile spermatozoa in the swim-up fraction [12.5 +/- 1.5 and 22.3 +/- 2.3 x 10(6)/ml for the 0 and the 100% fertilization groups, respectively (mean +/- SE; P less than 0.01)]. Thus, the swim-up migration technique can serve as a predictive test for the in vitro fertilizing capacity of sperm.