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OBJECTIVE: To develop a method whereby sperm with phosphatidylserine externalization can be separated from those without this feature. Because annexin V binds phosphatidylserine, this study is using this feature to select functional spermatozoa. In addition, the relationship between annexin V binding in human spermatozoa and normal sperm morphology according to strict criteria was to be assessed. DESIGN: Prospective study. SETTING: Department of Obstetrics and Gynaecology of Stellenbosch University at Tygerberg Academic Hospital, Tygerberg, South Africa. PATIENT(S): Semen from 14 healthy sperm donors. Exclusion criterion was the presence of less than 20 × 10⁶/mL total motile spermatozoa in the original sample. MAIN OUTCOME MEASURE(S): Annexin V-negative sperm, annexin V-positive sperm, normal sperm morphology. INTERVENTION(S): An aliquot of a semen sample after double …