scholarly journals Successful Pregnancy in a Couple with Severe Male Factor Infertility after Selection of Sperm with Cytoplasmic Droplets

2015 ◽  
Vol 2015 ◽  
pp. 1-4 ◽  
Author(s):  
Jenna Bellish ◽  
David H. McCulloh ◽  
Khaliq Ahmad ◽  
Peter G. McGovern

We present live births resulting from two separate IVF cycles in a couple in which ICSI was performed with sperm specifically selected for presence of small cytoplasmic droplets. These cycles followed previous cycles using standard sperm selection methods in which very poor embryo development and no pregnancies ensued. The male partner was diagnosed with severe male factor infertility including elevated DNA fragmentation.

2019 ◽  
Vol 112 (3) ◽  
pp. 483-490 ◽  
Author(s):  
Edson Borges ◽  
Bianca Ferrarini Zanetti ◽  
Amanda Souza Setti ◽  
Daniela Paes de Almeida Ferreira Braga ◽  
Rodrigo Rosa Provenza ◽  
...  

2019 ◽  
Vol 112 (3) ◽  
pp. e277
Author(s):  
Matheus de Castro Azevedo ◽  
Bianca Ferrarini Zanetti ◽  
Daniela Paes de Almeida Ferreira Braga ◽  
Amanda Souza Setti ◽  
Assumpto Iaconelli ◽  
...  

BMJ Open ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. e051058
Author(s):  
Sine Berntsen ◽  
Bugge Nøhr ◽  
Marie Louise Grøndahl ◽  
Morten Rønn Petersen ◽  
Lars Franch Andersen ◽  
...  

IntroductionOver the last decades, the use of intracytoplasmic sperm injection (ICSI) has increased, even among patients without male factor infertility. The increase has happened even though there is no evidence to support that ICSI results in higher live birth rates compared with conventional in vitro fertilisation (IVF) in cases with nonmale factor infertility. The lack of robust evidence on an advantage of using ICSI over conventional IVF in these patients is problematic since ICSI is more invasive, complex and requires additional resources, time and effort. Therefore, the primary objective of the IVF versus ICSI (INVICSI) study is to determine whether ICSI is superior to standard IVF in patients without severe male factor infertility. The primary outcome measure is first live birth from fresh and frozen-thawed transfers after one stimulated cycle. Secondary outcomes include fertilisation rate, ongoing pregnancy rate, birth weight and congenital anomalies.Methods and analysisThis is a two-armed, multicentre, randomised, controlled trial. In total, 824 couples/women with infertility without severe male factor will be recruited and allocated randomly into two groups (IVF or ICSI) in a 1:1 ratio. Participants will be randomised in variable block sizes and stratified by trial site and age. The main inclusion criteria are (1) no prior IVF/ICSI treatment, (2) male partner sperm with an expected count of minimum 2 million progressive motile spermatozoa following density gradient purification on the day of oocyte pick up and (3) age of the woman between 18 and 42 years.Ethics and disseminationThe study will be performed in accordance with the ethical principles in the Helsinki Declaration. The study is approved by the Scientific Ethical Committee of the Capital Region of Denmark. Study findings will be presented, irrespectively of results at international conferences and submitted for publication in peer-reviewed journals.Trial registration numberNCT04128904. Pre-results.


2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Y Cabell. Vives ◽  
P Belchin ◽  
C Lopez-Fernandez ◽  
M Fernandez-Rubio ◽  
J Guerrero-Sanchez ◽  
...  

Abstract Study question Is it useful to avoid sperm centrifugation in laboratory routine work to improve sperm quality and reproductive outcome in Assisted Reproduction Techniques (ART)? Summary answer Exclusion of sperm centrifugation for sperm selection using neat sperm samples (IO-lix), increases sperm quality in the collected subpopulation decreasing miscarriage rate after using ICSI. What is known already Inclusion of sperm centrifugation in ART is an aggressive intervention for sperm selection with ineludible production iatrogenic damage affecting sperm integrity. The application of IMSI, PICSI or microfluidic devices avoid sperm centrifugation and may improve the quality of the subsample obtained. However, these methodologies may result time consuming, expensive or producing poor results when the quality of the sperm is limited. We have already shown that a modified swim-up avoiding centrifugation (called IO-lix) is a low-cost and efficient alternative to microfluidic devices, recovers 100 times more concentration and reduces sperm DNA fragmentation with no significant differences to other methodologies. Study design, size, duration This is a retrospective study from 2018 to 2020 which includes patients with an average of age of 38.2 years using their own oocytes with ICSI as fertilization technique. Two aleatory groups of patients were made: Group 1: 88 cycles with 503 fertilized oocytes and 206 blastocysts were obtained with sperm samples processed by IO-lix and Group 2: 303 cycles, 1451 fertilized oocytes and 591 blastocysts using a standard “swim up” technique to process sperm. Participants/materials, setting, methods A total of 391 ICSI cycles were included in this retrospective study. The male factor was similar in both groups and they showed altered SDF previously to the cycle. We compared data of the motility and SDF of sperm samples before and after applying IO-lix and we analyzed by X2 contingence test differences on miscarriage rates between groups 1 and 2. Main results and the role of chance General sperm parameter changes after IO-lix showed that averaged sperm concentration observed in neat ejaculated samples was 62M/SD=46.4. Values obtained after IO-lix in the same samples were 12.3M/SD8.0. Averaged sperm motility in neat samples was 54%/SD=9.3 and 70.9%/SD=13.2 after IO-lix. Finally, sperm DNA fragmentation in neat samples was 35.8%/SD17.3, while these values decreased to 9.2%/SD=3.9 after IO-lix. About reproductive outcome results, significant differences were not obtained on the development to blastocyst stage rate comparing both groups (X2=0.003; p value = 0.954; Alpha 0.05). In the case of IO-lix processed samples, the pregnancy rate was 59.42% in Group 1 and 44.72% in Group 2 (X2=0.651; p value =0.419; Alpha 0.05). A total of 9 miscarriages of 41 clinical pregnancies (21.95%) were observed after IO-lix, while this number increases to 59 out of 123 clinical pregnancies, which means the 47.96% of the embryo transfers, when “swim-up” was used. In this case significant differences were obtained (X2=3.935; p value = 0.0.047; Alpha 0.05). Limitations, reasons for caution Being a pilot study aimed to understand the results of IO-lix in ART, correlations have not been stablished between the levels of sperm improvement after IO-lix and paired results of ART. This study would be necessary, specially to identify the possible origin of miscarriage associated to the male factor. Wider implications of the findings: Elimination of sperm centrifugation using a combined strategy of gradients and “swim-up” for sperm isolation, reduce miscarriage rate and produce equivalent results of blastocyst development to those obtained with “swim-up”. Being a cost-effective and improving laboratory workload, its use for sperm selection is recommended. Trial registration number Not applicable


Reproduction ◽  
2017 ◽  
Vol 154 (6) ◽  
pp. F71-F77 ◽  
Author(s):  
Zev Rosenwaks ◽  
Nigel Pereira

Intracytoplasmic sperm injection (ICSI) has often been heralded as a ground-breaking technique that has transformed the treatment of couples with infertility. By injecting a single spermatozoon into the cytoplasm of the oocyte, ICSI bypasses the zona pellucida and increases the chances of fertilization and subsequent embryo development, independent of semen parameters. Ever since the first live births using ICSI were reported in 1992, ICSI has become the mainstay of treating male factor infertility as well as overcoming fertilization failure associated with conventional in vitro insemination. Today, ICSI is utilized in nearly 66% of all assisted reproductive treatments worldwide and has resulted in the birth of millions of babies. The primary goal of this review is to provide historical perspectives about the pioneering of ICSI. We begin by highlighting the scientific work of early investigators who elucidated the mechanisms central to mammalian fertilization. Furthermore, we briefly discuss how these findings contributed to the development of IVF for the treatment of infertility. We then emphasize the shortcomings of IVF in treating severe forms of male factor infertility and enumerate the micromanipulation techniques that were developed to circumvent these shortcomings. Finally, we indicate how the inadequacies of these micromanipulation techniques lead to the inception, application and popularity of ICSI.


2020 ◽  
Vol 19 (2) ◽  
pp. 41-45
Author(s):  
Mafruha Khanam ◽  
Rokeya Begum ◽  
Aditi Banerjee ◽  
Jesmin Jerin ◽  
Mohamed Mazih Fazyl ◽  
...  

Background: Intrauterine Insemination (IUI) is one of the most common assisted reproductive technology methods in the world to treat various forms of infertility. The influence of number of IUI applied with the percentage of motile spermatozoa during insemination is critical on the likelihood of a successful pregnancy. The aim of our study is to assess the results of IUI as a function of the number of IUI applied with motile spermatozoa inseminated during intrauterine insemination in couples with infertility. Materials and methods: This is a prospective study conducted in Surgiscope Fertility Centre, Chattogram, Bangladesh over 21 months on 596 couples who underwent IUI from 01/12/2017 to 30/09/2019. We performed semen analysis of the male partner from the couples who underwent IUI, calculated the sperm motility and the relationship between number of IUI applied with motile spermatozoa and the pregnancy rate of IUI. Multiple variables were selected such as, patient parameters like age of female, number of IUI, percentage of motile spermatozoa inseminated, endometrial thickness and ovulation induction protocol which were recorded and statistically analyzed. Results: Among the 596 patients, the overall success rate was 11%. The maximum number of successes were observed in patients with 3 IUI applications whereas the success rate was lower in comparison with decreasing IUI applications. The regression between the success and number of insemination and age indicate that there is a statistically significant positive relationship between number of inseminations completed and the rate of successful pregnancy, but no significant relationship between the number of prewash sperm and successful pregnancy. These could be due to lower population size. As an ovulation inducing agent, a 12.42% success rate was observed among the patients administered with FSH whereas 9.28% was observed for patients administered with GONAL F. The mean endometrial thickness was observed to be 8.914 mm with a minimum thickness of 4.5 mm and a maximum thickness of 19 mm. Conclusion: The rationale for the use of insemination is to increase gamete density at the site of fertilization. This revealed that intrauterine insemination should be a firstchoice treatment rather than more invasive and expensive techniques of assisted reproduction in cases of cervical, unexplained and moderate male factor subfertility. Chatt Maa Shi Hosp Med Coll J; Vol.19 (2); July 2020; Page 41-45


Reproduction ◽  
2021 ◽  
Vol 161 (3) ◽  
pp. 343-352 ◽  
Author(s):  
Jon Romero-Aguirregomezcorta ◽  
Ricardo Laguna-Barraza ◽  
Raúl Fernández-González ◽  
Miriama Štiavnická ◽  
Fabian Ward ◽  
...  

The objective of this work was to elucidate whether a sperm selection method that combines rheotaxis and microfluidics can improve the selection of spermatozoa over density gradient and swim-up. For this purpose human sperm selected by rheotaxis were compared against density gradient, swim-up and a control group of non-selected spermatozoa in split frozen-thawed (FT) and fresh (F) semen samples. Sperm quality was assessed in terms of motility, morphology, DNA fragmentation index (DFI), viability, acrosome integrity and membrane fluidity. Using a mouse model, we compared fertilisation and embryo development rates after performing ICSI with spermatozoa, sorted using rheotaxis or swim-up. Selection by rheotaxis yielded a sperm population with reduced DFI than the control (P < 0.05), improved normal morphology (P < 0.001) and higher total motility (TM; P < 0.001) than the other techniques studied in F and FT samples. Swim-up increased TM compared to density gradient and control in FT or F samples (P < 0.001), and yielded lower DFI than the control with F samples (P < 0.05). In FT samples, selection by rheotaxis yielded sperm with higher viability than control, density gradient and swim-up (P < 0.01) while acrosomal integrity and membrane fluidity were maintained. When mouse spermatozoa were selected for ICSI using rheotaxis compared to swim-up, there was an increase in fertilisation (P < 0.01), implantation (P < 0.001) and foetal development rates (P < 0.05). These results suggest that, in the absence of non-destructive DNA testing, the positive rheotaxis can be used to select a population of low DNA fragmentation spermatozoa with high motility, morphology and viability, leading to improved embryo developmental rates.


1994 ◽  
Vol 6 (1) ◽  
pp. 63
Author(s):  
L Gianaroli ◽  
MC Magli ◽  
AP Ferraretti ◽  
D Fortini ◽  
E Feliciani ◽  
...  

One hundred and sixteen couples with severe male factor infertility underwent 139 subzonal sperm microinjection cycles. In total, 1343 oocytes were microinjected, resulting in a fertilization rate of 24%, followed by a cleavage rate of 65%. In 26% of the zygotes, fertilization was delayed and embryos derived from these zygotes demonstrated a poor capacity for further growth and implantation. In 102 of 139 cycles (73%) embryo transfer was performed, resulting in 9 pregnancies. This study followed the fate of injected oocytes and early embryo development to investigate biological factors that influence the results of subzonal injection.


Andrologia ◽  
2012 ◽  
Vol 45 (4) ◽  
pp. 240-247 ◽  
Author(s):  
T. Irez ◽  
P. Ocal ◽  
O. Guralp ◽  
S. Kaleli ◽  
F. Ocer ◽  
...  

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