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The objective of this prospective diagnostic study was to explore the relationships between the morphological indices of sperm using motile sperm organelle morphology examination (MSOME) and the clinical outcome of in vitro fertilization (IVF). A total of 291 couples were included in this study. The female patients exhibited tubal and pelvic factors, and their partners' gametes were tested prospectively by MSOME. Spearman correlation analysis was used to identify the relationship between MSOME and IVF rates and conventional sperm parameters. The effect of MSOME characteristics on pregnancy outcome was analyzed by multivariate logistic regression. MSOME characteristics showed statistical relationships with sperm concentration (R = 0.130, P = 0.025), progressive motility (R = 0.260, P < 0.001), and strict normal morphology (P = 0.648, R < 0.001). The percentage of sperm with normal morphology and vacuolation in the anterior head of the sperm, as observed by MSOME, was highly correlated with the IVF fertilization rate (R = 0.176, P = 0.002; P = − 0.230, P < 0.001 respectively). The combined incidence of morphologically normal sperm and posterior vacuolation of the sperm head, as assessed by MSOME, was a predictor of clinical pregnancy (CP) after IVF (sensitivity, 92.9%; specificity, 42.47; and area under the ROC curve, 76.59%). The percentage of normal morphology of sperm by MSOME (OR 3.52, 95% CI 2.05–6.05, P < 0.001) and the posterior part vacuolated sperm (OR 0.65, 95% CI 0.52–0.82, P < 0.001) were significant predictors of successful CP. The MSOME index was significantly correlated with fertilization rates and CP after IVF, and testing with MSOME could constitute a valid diagnostic predictor of IVF outcome. [ABSTRACT FROM AUTHOR]

Objective Methods Results Conclusion The aim of the present study was to investigate the incidence of intrahepatic cholestasis of pregnancy (ICP) as well as neonatal outcomes between conception via in vitro fertilization (IVF) compared with spontaneous conception (SC) and screen the risk factors of ICP in IVF.This retrospective cohort study included 4467 puerperae who conceived via IVF, and 28 336 puerperae who conceived spontaneously and linked the information from neonates. The general linear model (GLM), multivariate logistic regression analysis, a forest plot, and nomogram were used to assess impact factors and risk prediction.Logistic analysis adjusted for confounders revealed significant differences in the ICP rate of singleton delivery (4.24% vs 3.41%, adjusted OR [aOR] = 1.26; 95% confidence interval [CI] 1.03–1.53, P = 0.025) and in groups with total bile acids (TBA) ≥40 and <100 μmol/L (14.77% vs 10.39%, aOR = 1.31; 95% CI: 1.06–1.63, P = 0.023) between IVF and SC. When we divided newborns into singleton and twins delivery, the GLM revealed a higher rate with Apgar score <7 (13.44% vs 3.87%, aOR = 3.85; 95% CI: 2.07–7.17, P < 0.001) and fetal distress for IVF in comparison with SC (19.32% vs 5.55%, OR = 3.48; 95% CI: 2.39–6.95, P < 0.001) in the singleton group. In multivariate logistic regression analysis, body mass index (BMI) (aOR = 1.29; P = 0.031), number of embryo transfers (ET) (single ET vs double ET, aOR = 2.82; P < 0.001), E2 level on the ET day (aOR = 2.79; P = 0.011), fresh ET which compared with frozen ET (FET) (aOR = 1.45; P = 0.014), embryo stage (cleavage embryo vs blastocyst, aOR = 1.75; P = 0.009) and severe ovarian hyperstimulation syndrome (OHSS) which compared with non‐OHSS (aOR = 3.73; P = 0.006) were independent predictors of ICP. These predictive factors in the logistic regression model were integrated into the nomogram (C‐index = 0.735; 95% CI: 0.702–0.764); for each patient, higher total points indicated a higher risk of ICP.We observed that the ICP rate of singleton delivery was higher in IVF than in SC. In ICP patients, there were higher rates of neonatal Apgar score <7 and fetal distress in IVF than SC and found the predictors of ICP in IVF. [ABSTRACT FROM AUTHOR]