{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T12:34:25Z","timestamp":1792154065054,"version":"4.4.0"},"reference-count":33,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2025,5,27]],"date-time":"2025-05-27T00:00:00Z","timestamp":1748304000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"University of Oradea, Romania"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: Sperm morphology is a key factor influencing fertilization and embryo development in assisted reproductive technology (ART). However, the predictive value of sperm deformity indices and selection techniques remains debated. This study evaluated the impact of teratozoospermia on fertilization, blastocyst formation, and embryo quality, comparing conventional and microfluidic sperm selection methods. Methods: A retrospective analysis was conducted on ART cycles involving patients with teratozoospermia. Sperm selection was performed using density gradient centrifugation (DGC) or microfluidic sperm sorting (MFSS). The correlations between the Sperm Deformity Index (SDI), Multiple Anomalies Index (MAI), and Teratozoopermia Index (TZI) with fertilization rates, blastocyst formation, and embryo quality were assessed. Statistical analysis included correlation tests, receiver operating characteristic (ROC) curves, and independent samples t-tests. Results: Patients with severe teratozoospermia exhibited lower fertilization rates (p &lt; 0.01) and reduced blastocyst formation (p = 0.02). The SDI and MAI showed moderate negative correlations with fertilization (r = \u22120.15 and r = \u22120.25, respectively) and blastocyst development (r = \u22120.20 and r = \u22120.30, respectively), while the TZI had only weak associations (r = \u22120.10 and r = \u22120.15, respectively). ROC analysis demonstrated that the SDI and MAI were moderate predictors of embryo viability (AUC = 0.70 and 0.75, respectively). Patients who underwent microfluidic sperm selection had higher fertilization rates (p = 0.03) and improved blastocyst quality (p = 0.04) than those processed with DGC. Conclusions: Severe teratozoospermia negatively affects fertilization and blastocyst formation, with the SDI and MAI showing moderate predictive value for embryo development. The use of microfluidic sperm selection significantly improved embryo quality, supporting its clinical relevance in ART.<\/jats:p>","DOI":"10.3390\/jcm14113763","type":"journal-article","created":{"date-parts":[[2025,5,28]],"date-time":"2025-05-28T03:52:08Z","timestamp":1748404328000},"page":"3763","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Teratozoospermia and Embryo Development: The Significance of Sperm Selection in In Vitro Fertilization Success"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1440-3965","authenticated-orcid":false,"given":"Petronela","family":"Naghi","sequence":"first","affiliation":[{"name":"Calla\u2014Infertility Diagnostic and Treatment Center, Constantin A. Rosetti Street, 410103 Oradea, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ioana Alexandra","family":"Zaha","sequence":"additional","affiliation":[{"name":"Calla\u2014Infertility Diagnostic and Treatment Center, Constantin A. Rosetti Street, 410103 Oradea, Romania"},{"name":"Faculty of Medicine and Pharmacy, University of Oradea, 1st December Square 10, 410073 Oradea, Romania"},{"name":"Pelican Clinical Hospital, Corneliu Coposu Street 2, 410450 Oradea, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liana","family":"Stefan","sequence":"additional","affiliation":[{"name":"Calla\u2014Infertility Diagnostic and Treatment Center, Constantin A. Rosetti Street, 410103 Oradea, Romania"},{"name":"Faculty of Medicine and Pharmacy, University of Oradea, 1st December Square 10, 410073 Oradea, Romania"},{"name":"Oradea County Hospital, Gheorghe Doja Street 65\u201367, 410169 Oradea, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Sorian","sequence":"additional","affiliation":[{"name":"Calla\u2014Infertility Diagnostic and Treatment Center, Constantin A. Rosetti Street, 410103 Oradea, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adelin","family":"Marcu","sequence":"additional","affiliation":[{"name":"Calla\u2014Infertility Diagnostic and Treatment Center, Constantin A. Rosetti Street, 410103 Oradea, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7701-2307","authenticated-orcid":false,"given":"Liliana","family":"Sachelarie","sequence":"additional","affiliation":[{"name":"Department of Clinical Discipline, Apollonia University, 700511 Iasi, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anca","family":"Huniadi","sequence":"additional","affiliation":[{"name":"Calla\u2014Infertility Diagnostic and Treatment Center, Constantin A. Rosetti Street, 410103 Oradea, Romania"},{"name":"Faculty of Medicine and Pharmacy, University of Oradea, 1st December Square 10, 410073 Oradea, Romania"},{"name":"Pelican Clinical Hospital, Corneliu Coposu Street 2, 410450 Oradea, Romania"},{"name":"Oradea County Hospital, Gheorghe Doja Street 65\u201367, 410169 Oradea, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,5,27]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"535","DOI":"10.1093\/humupd\/dmy017","article-title":"The Contribution of Human Sperm Proteins to the Development and Epigenome of the Preimplantation Embryo","volume":"24","author":"Castillo","year":"2018","journal-title":"Hum. Reprod. 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