How to improve IVF-ICSI outcome by sperm selection.

In previous studies, a new IVF method of intracytoplasmic morphologically selected sperm injection (IMSI) was introduced, based on motile sperm organellar morphology examination (MSOME). It was concluded that microinjection of morphologically selected sperm cells with strictly normal nucleus, defined by MSOME, improves IVF-ICSI outcome. The aim of the present study was to confirm this conclusion in new, enlarged study groups. Comparison between 80 couples, who underwent an IVF-IMSI trial, with matched couples, who underwent a standard IVF-ICSI procedure, confirmed that pregnancy rate following IVF-IMSI was significantly higher, and abortion rate significantly lower than in the routine IVF-ICSI (60.0 versus 25.0%, and 14 versus 40% respectively, P <or= 0.05). Another comparison was performed between matched IMSI groups, where embryos were obtained from microinjection by spermatozoa with a morphologically normal nucleus ('best' group, n = 70) and a 'second best' group was selected, where embryos were obtained from microinjection of spermatozoa with minimal morphological impairment, since no other sperm cells were available. It was confirmed that microinjection by 'second best ' spermatozoa result in significantly lower pregnancy and delivery rates and significantly higher abortion rates than microinjection with 'best' spermatozoa (25.7 versus 58.2%, P <or= 0.01; 17.1 versus 52.8%, P <or= 0.01, and 33.3 versus 9.7%, P <or= 0.02 respectively). The present study has strengthened previous conclusions.

[1]  N. Burrello,et al.  High sperm aneuploidy rate in unselected infertile patients and its relationship with intracytoplasmic sperm injection outcome. , 2001, Human reproduction.

[2]  A. Agarwal,et al.  Lower sperm aneuploidy frequency is associated with high pregnancy rates in ICSI programmes. , 2003, Human reproduction.

[3]  J. Langzam,et al.  Improved diagnosis of male fertility potential via a combination of quantitative ultramorphology and routine semen analyses. , 1994, Human reproduction.

[4]  Moulavi Fariba,et al.  Effect of sperm DNA damage and sperm protamine deficiency on fertilization and embryo development post-ICSI. , 2005 .

[5]  B. Fisch,et al.  The relationship between sperm ultrastructural features and fertilizing capacity in vitro. , 1992, Fertility and sterility.

[6]  E. Vicari,et al.  Absolute polymorphic teratozoospermia in patients with oligo-asthenozoospermia is associated with an elevated sperm aneuploidy rate. , 2003, Journal of andrology.

[7]  M. Virro,et al.  Sperm chromatin structure assay (SCSA) parameters are related to fertilization, blastocyst development, and ongoing pregnancy in in vitro fertilization and intracytoplasmic sperm injection cycles. , 2004, Fertility and sterility.

[8]  J. Langzam,et al.  Quantitative ultramorphological analysis of human sperm: fifteen years of experience in the diagnosis and management of male factor infertility. , 1999, Archives of andrology.

[9]  A. Barnes,et al.  Sperm chromatin structure assay parameters as predictors of failed pregnancy following assisted reproductive techniques. , 2000, Human reproduction.

[10]  Y. Beyth,et al.  ART success and in vivo sperm cell selection depend on the ultramorphological status of spermatozoa , 1999, Andrologia.

[11]  A Berkovitz,et al.  Selection of spermatozoa with normal nuclei to improve the pregnancy rate with intracytoplasmic sperm injection. , 2001, The New England journal of medicine.

[12]  S. Yaari,et al.  The morphological normalcy of the sperm nucleus and pregnancy rate of intracytoplasmic injection with morphologically selected sperm. , 2005, Human reproduction.

[13]  I. Hinduja,et al.  Comparison of the sperm aneuploidy rate in severe oligozoospermic and oligozoospermic men and its relation to intracytoplasmic sperm injection outcome. , 2005, Fertility and sterility.

[14]  J. Check,et al.  EFFECT OF AN ABNORMAL SPERM CHROMATIN STRUCTURAL ASSAY (SCSA) ON PREGNANCY OUTCOME FOLLOWING (IVF) WITH ICSI IN PREVIOUS IVF FAILURES , 2005, Archives of andrology.

[15]  B. Lunenfeld,et al.  Infertility, male and female , 1986 .

[16]  M. Nasr-Esfahani,et al.  Relationship between protamine deficiency with fertilization rate and incidence of sperm premature chromosomal condensation post‐ICSI , 2004, Andrologia.

[17]  Yona Barak,et al.  Pregnancy rates are higher with intracytoplasmic morphologically selected sperm injection than with conventional intracytoplasmic injection. , 2003, Fertility and sterility.

[18]  Yona Barak,et al.  Real-time fine morphology of motile human sperm cells is associated with IVF-ICSI outcome. , 2002, Journal of andrology.

[19]  C. Peterson,et al.  SPERM CHROMOSOME ANEUPLOIDY AS RELATED TO MALE FACTOR INFERTILITY AND SOME ULTRASTRUCTURE DEFECTS , 2004, Archives of andrology.