Análisis documental y bioestadístico de los métodos de evaluación morfológica de espermatozoides humanos en una clínica de medicina reproductiva en Guayaquil, Ecuador

Abstract

Infertility is a significant health issue affecting a large portion of the global population, with sperm morphology evaluation being crucial in diagnosing and treating this condition. Although traditional methods based on WHO parameters are widely used, they may not be sufficient for an accurate diagnosis. In response, the sixth edition of the WHO laboratory manual (2021) recommended the implementation of indices such as the Teratozoospermia Index (TZI), Multiple Anomalies Index (MAI), and Sperm Deformity Index (SDI). These indices allow for a more detailed assessment of sperm defects, providing a more precise guide for selecting treatments and assisted reproductive techniques. This retrospective, descriptive, correlational, and comparative study was conducted at a reproductive medicine clinic in Guayaquil, Ecuador, from January to May 2024. It analyzes the relationship between these indices and other fundamental seminal parameters to determine their relevance and applicability in reproductive medicine. A sample of thirty patients was selected using non-probabilistic convenience sampling. The findings underscore the pivotal role of sperm morphology in assessing semen quality and its influence on male fertility. The correlations between different morphological indices and seminal parameters indicate that morphological abnormalities, particularly in the sperm neck, can significantly affect motility and fertilizing capacity. The MAI index, with its strong correlations with head and neck abnormalities, emerges as a comprehensive method for an integral evaluation. Conversely, the TZI is effective in detecting neck abnormalities, but its utility is limited in other areas. The study also highlights the need for further research due to the ongoing debate in the literature about the correlation between sperm morphology and other seminal parameters. It is important to note the study's limitations, such as the short analysis period, to ensure that reproductive medicine professionals and clinicians in the audience are aware of the potential challenges in the field.