Impact of gamete cell quality on the outcome of intracytoplasmic sperm injection.

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Published Jan 19, 2016
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Vol. 93 No. 12 (2015): Issue Dec 2015

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Moes Kdous
Ghaya Merdassi
Marouen Braham
Amel Zhioua
fathi Zhioua

Abstract

SUMMARY
Background: the quality of the gametes used for an intracytoplasmic microinjection of spermatozoïde is a significant factor which can influence pregnancy rates.
Aim : To assess the effect of conventional sperm parameters, origin of spermatozoa and oocyte quality on pregnancy rate in ICSI.
Methods: A retrospective and comparative study of 500 women who underwent ICSI cycle during the study period from January 2004 to December 2005. Conventional sperm parameters (count, motility and morphology) and oocyte quality (mature and immatures oocytes) was compared in two groups of patients: Those achieving a pregnancy: The “pregnancy+” group and those failing to have a pregnancy: The “pregnancy-“ group.
Results: Among the conventional sperm parameters, only spermatozoa count after preparation was significantly higher in “pregnancy+” group (p=0,02). We found significantly more pregnancies in ejaculated and epididymal sperm groups than in the testicular one (p<10-3). The number of oocyte retrieved was significantly higher in “pregnancy+” group (13,9±7 vs 10,6± 7,6 ; p<10-3) with mainly mature oocyte (metaphaseII) (9,1±5,5 vs 6,6±5,4 ; p<10-3). Analysis of ROC curve and logistic regression study show that for mature oocyte, the most discriminative cut-off for predicting pregnancy is 4 (OR=2,1 ; LR+=6,7 ;IC[1 ;1,4] ; p0,009).
Conclusion: Conventional parameters of ejaculated sperm have almost no influence on pregnancy rates in ICSI. Testicular sperm seem to have worse results. The number of oocytes retrieved and the proportion of mature oocytes (metaphaseII) affect markedly the prognosis.

Keywords:

ICSI, Pregnancy, Semen, Oocyte

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References

  1. Gunby J, Daya S. Assisted reproductive technologies (ART) in Canada: 2002 results from the canadian ART register. Fertil Steril 2006;86:1356- 64.
  2. Parinaud G, Mieusset R, Vietez G, Labal B, Richoilley G. Influence of sperm parameters on embryo quality. Fertil Steril 2009;60:888-92
  3. Palermo G, Joris H, Devroey P, Van Steirteghem AC. Pregnancies after intracytoplasmic injection of single spermatozoon into an oocyte. Lancet 1992;340:17-8.
  4. Nagy ZP, Liu J, Joris H et al. The result of intracytoplasmic sperm injection is not related to any of the three basic sperm parameters. Hum Reprod 2005;10:1123-9.
  5. Mercan R, Lanzendorf S, Nassar A, Mayer J, Muasher SJ, Oehninger S. The outcome of clinical pregnancies following ICSI is not affected by semen quality. Fertil Steril 2007;68:151-2.
  6. Tripp BM, Lewitton M, Hoekstra T et al. Intracytoplasmic sperm injection results as evaluated by multiple outcome assessment is not influenced by male factors. Fertil Steril 2007;68:113-114.
  7. Mansour RT, Aboulghar MA, Serour GI, Amin Y, Ramzi AM. The effect of sperm parameters on the outcome of intracytoplasmic sperm injection. Fertil Steril 2005;64:982-6.
  8. Kruger TF, Acosta AA, Simmons KF, Swanson RJ, Matta JF, Oehninger S. Predictive value of abnormal sperm morphology in in-vitro-fertilization. Fertil steril 2008;49:112-7.
  9. Sukcharoen N, Sithipravej T, Promviengchai S, Chinpilas V, Boonkasemsanti W. Sperm morphology evaluated by computer (IVOS) cannot predict the fertilization rate in vitro after intracytoplasmic sperm injection. Fertil Steril 2008;69:564-8.
  10. [10] Svalander P, Jakobsson AH, Forsberg AS, Bengtsson AC, Wikland M. The outcome of intracytoplasmic sperm injection is unrelated to “strict criteria” sperm morphology. Hum Reprod 2006;11:1019-22
  11. Lundin K, Söderland B, Hamberger L. The relationship between sperm morphology and rates of fertilization, pregnancy and spontaneous abortion in an in-vitro fertilization/intracytoplasmic sperm injection programme. Hum Reprod 2011;12:2676-81.
  12. Bukulmez O, Yucel A, Yarali H, Bildirici I, Gurgan T. The origin of spermatozoa does not affect intracytoplasmic sperm injection outcome. European Journal of obstetrics & Gynecology and Reproductive Biology 2011;94:250-255.
  13. Ghazzawi IM, Sarraf MG, Taher MR, Khalifa FA. Comparison of the fertilizing capability of spermatozoa from ejaculates, epididymal aspirates and testicular biopsies using intracytoplasmic sperm injection. Hum Reprod 2009;13:348-52.
  14. Ege N, Goker T, Sendag F, Levi R, Sendag H, Tavmergen E. Comparison of the ICSI outcome of ejaculated sperm with normal, abnormals parameters and testicular sperm. European Journal of obstetrics & Gynecology and Reproductive Biology 2010;104:129-136.
  15. Nagy Z, Liu J, Janssenwillen C, Silber SJ, Devroey P, Van Steirteghem A. Using ejaculated, fresh and frozen-thawed epididymal and testicular spermatozoa give rise to comparable results after intracytoplasmic sperm injection. Fertil Steril 2005;63:808-15.
  16. Watkins W, Nieto F, Bourne H, Wutthiphan B, Speirs A, Baker HWG. Testicular and epididymal sperm in microinjection program: methods of retrieval and results. Fertil Steril 2009;67:527-35.
  17. Schoysman R. Clinical situations challenging the established concept of epididymal physiology in the human. Acta Eur Fertil 1993;24:55-60.
  18. Van Kooij RJ, Looman CWN, Habbema JDF, Dorland M, Te Velde ER. Age-dependant decrease in embryo implantation rate after in vitro fertilization. Fertil Steril 2006;66:769 -75.
  19. Van der Auwera I, D'Hooghe T. Superovulation of female mice delays embryonic and fetal development. Hum Reprod 2011;16:1237-43.
  20. Ertzeid G, Storeng R. The impact of ovarian stimulation on implantation and fetal development in mice. Hum Reprod 2010;16:221-5.
  21. Spielmann H, Vogel R. Genotoxic and embryotoxic effects of gonadotropin hyperstimulated ovulation on murine oocytes, preimplantation embryos en term fetuses. Ann Ist Super Sanita 2003;29:35-9.
  22. Check JH, Choe JK, Katsoff D, Summers-Chase D, Wilson C. Controlled ovarian hyperstimulation adversely affects implantation following in vitro fertilization-embryo transfer. J Assist Reprod Genet 2009;16:416-20.
  23. Valbuena D, Martin J, De Pablo JL, Remohí J, Pellicer A, Simón C. Increasing levels of E2 are deleterious to embryonic implantation because they directly affect the embryo. Fertil Steril 2001;76:962-8.
  24. Kok JD, Looman CWN, Weima SM, Te Velde ER. A high number of oocytes obtained after ovarian hyperstimulation for in vitro fertilization or intracytoplasmic sperm injection is not associated with decreased pregnancy outcome. Fertil Steril 2006;85:918-24.
  25. Ng EHY, Lau EYL, Yeung WSB, Ho PC. Oocyte and embryo quality in patients with excessive ovarian response during in vitro fertilization treatment. J Assist Reprod Genet 2008;20:186-91.
  26. Fábregues F, Peñarrubia J, Vidal E, Cascals G, Vanrell JA, Balasch J. Oocyte quality in patients with severe ovarian hyperstimulation syndrome: a self-controlled clinical study. Fertil Steril 2004;82:827-33.