Objective: To investigate the effects of sperm morphology and their co-incubation with oocytes on the outcome of IVF and ICSI. Design: Strict morphology of washed sperm was assessed by Diff-Quick staining method before or after insemination. And the relationships between strict morphology and outcome (fertilization, embryo development and pregnancy) of IVF(with co-incubation) and ICSI (without co-incubation) were determined. Patients: Two-hundreds-and-sixty-three cycles of IVF and ninety-six cycles of ICSI were analyzed in order to clarify the influence of strict sperm morphology of spermatozoa on outcome of IVF and ICSI. These were divided into four groups. according to fertilization method and sperm morphology(Group 1: IVF, ${geq}$12%, n:227; Group 2: IVF, <12%, n:36; Group 3: ICSI, ${geq}$ 12%, n=48; Group 4: ICSI, <12%, n=48). Results: The fertilization rates of better morphology groups were higher than those of poor groups: Group 1(68.1%) > Group 2(62.1%), Group 3(78.1%) > Group 4(71.5%). There was no difference in embryo cleavage rates among four groups (>90%), Regarded with the good embryo rates, Group 1(56.8%) was significantly higher than Group 2(42.3%)(P<0.01), but there was no difference between Group 3(64.7%) and Group 4(61.2%). The pregnancy rates were also higher in better morphology groups as well as fertilization rates: Group 1(34.8%)> Group 2(16.7%)(p<0.05), Group 3(40.0%) > Group 4(23.0%)(p=0.08). Conclusion: Co-incubation with poor morphology sperm might adversely affect the quality of embryos. And strict sperm morphology may represent the ability to establish successful pregnancy. In short, the strict sperm morphology can be a good predictor of IVF and ICSI outcome.