A new real-time morphology classification for human spermatozoa: a link for fertilization and improved embryo quality (original) (raw)
Related papers
Improving ICSI: A review from the spermatozoon perspective
Systems Biology in Reproductive Medicine, 2016
Intracytoplasmic sperm injection (ICSI) is the most frequently applied method for fertilization making the process of identifying the perfect spermatozoon fundamental. Herein we offer a critical and thorough presentation on the techniques reported regarding (i) handling and preparing semen samples, (ii) identifying and 'fishing' spermatozoa, and (iii) improving key factors, such as motility for a successful ICSI practice. These approaches are suggested to make the process easier and more effective especially in atypical and challenging circumstances. Furthermore, we present an epigrammatic opinion-where appropriate-based upon our collective experience. Techniques such as intracytoplasmic morphologically selected sperm injection, hyaluronic binding, polarized light microscopy, and annexin V agent identification for comparing sperm cells and their chromatin integrity are analyzed. Moreover, for the demanding cases of total sperm immotility the use of the hypoosmotic swelling test, methylxanthines, as well as the option of laser assisted immotile sperm selection are discussed. Finally, we refer to the employment of myoinositol as a way to bioreactively improve ICSI outcome for oligoasthenoteratozoospermic men. The diversity and the constant development of novel promising techniques to improve ICSI from the spermatozoon perspective, is certainly worth pursuing. The majority of the techniques discussed are still a long way from being established in routine practices of the standard IVF laboratory. In most cases an experienced embryologist could yield the same results. Although some of the techniques show great benefits, there is a need for large scale multicenter randomized control studies to be conducted in order to specify their importance before suggesting horizontal application. Taking into consideration the a priori invasive nature of ICSI, when clinical application becomes a possibility we need to proceed with caution and ensure that in the pursuit for innovation we are not sacrificing safety and the balance of the physiological and biological pathways of the spermatozoon's dynamic.
Journal of Assisted Reproduction and Genetics, 2011
Purpose We used computer assisted sperm selection (MSOME) during cycles of intracytoplasmic sperm injection to test whether this technique improves results over traditional ICSI protocols. We also used the TUNEL assay to test whether MSOME could deselect physiologically abnormal spermatozoa. Methods Individual spermatozoa were examined with MSOME. Normal and abnormal spermatozoa were tested for the level of DNA fragmentation using TUNEL assay. In a prospective, randomized trial, patients were selected for standard ICSI, or IMSI techniques. We tested the two groups for biological and clinical parameters. Results 64.8% of spermatozoa, otherwise selectable for ICSI, were characterized by abnormalities after computer-assisted sperm analysis. These sperm were also characterized by an increase in the level of DNA fragmentation. We noted an increase in embryo quality, pregnancy and implantation rates after computerized sperm selection during ICSI procedures. Conclusions Computerised selection of spermatozoa during ICSI procedures deselects physiological abnormal spermatozoa and improves clinical results.
Reproductive Sciences, 2021
This retrospective cohort study aimed to explore whether paternal age and semen quality parameters affect the embryological and clinical outcomes of ICSI with oocyte donation. A total of 339 oocyte donation (OD)-ICSI cycles were categorized into four groups according to the semen parameter profiles of the male counterparts: normozoospermia (NS, n = 184), oligozoospermia (OS, n = 41), asthenozoospermia (AS, n = 50), and oligoasthenozoospermia (OAS, n = 64). The effect of age, total sperm count, and progressive motility was separately analyzed for reproductive outcomes and compared between the study groups: fertilization, blastulation, and top-quality embryo rate, biochemical and clinical pregnancy, live birth, and miscarriage. A negative correlation between male age and fertilization rate was observed (r s = − 0.23, p < 0.0001), while male age was a significant factor for biochemical pregnancy (p = 0.0002), clinical pregnancy (p = 0.0017), and live birth (p = 0.0038). Reduced total sperm count and lowered progressive motility led to poorer fertilization rates (r s = 0.19 and 0.35, respectively, p < 0.0001) and affected embryo quality (r s = 0.13, p = 0.02, and r s = 0.22, p < 0.0001, respectively). OD-ICSI cycles with asthenozoospermia had significantly lowered success rates in biochemical pregnancy, clinical pregnancy, and live birth (p < 0.05). Our study demonstrated that both advanced male age and reduced progressive motility of spermatozoa exert a significant negative influence on the outcome of assisted reproduction, even in controlled procedures with gamete selection and optimization such as in OD-ICSI. Improvement in treatment strategies and male fertility evaluation requires incorporation of such evidence to obtain better prognosis towards personalized management.
Sperm morphology: What implications on the assisted reproductive outcomes?
Andrology, 2020
ObjectiveTo evaluate the impact of sperm morphology (SM) on laboratory and pregnancy outcomes in conventional intracytoplasmic sperm injection (c‐ICSI) cycles, using the egg donation model to minimize female confounding variables.Materials and methodsWe retrospectively collected data of oocyte donation cycles from October 2016 to February 2020. Median seminal parameters, total (1‐2‐3PN) fertilization rate (FR), 2PN FR, cleavage rate (CR), implantation rate (IR), pregnancy rate (PR), miscarriage rate (MR), and live birth rate (LBR) were collected. The study population was divided into three groups: Group 1 with SM < 4%, Group 2 with SM between 4% and 6%, and Group 3 with SM > 6%.ResultsOf 741 fresh ICSI cycles and 4507 warmed oocytes were included. Male age was 46.0 (31.0‐72.0) years, and recipients’ age was 44.0 (29.0‐54.0) years. Normal SM was 5.0% (1.0%‐15.0%). Male age was negatively correlated with normal SM (P = .002; Rho −0.113). Oocyte survival rate was 83.3% (16.7%‐100...
Medical Journal of Babylon, 2015
The aim of this study was to compare different intracytoplasmic sperm injection (ICSI) parameters with its outcome and predict the most important factor that relate with successful rate. A total seventy-five infertile women aged between 22-45 years(31.43 ± 5.38 years), referred to the fertility clinic in Al-Sadder teaching hospital, , and undergone intracytoplasmic sperm injection throughout period from March 2013 to January 2014,were included in this study. Fertilization rate (FR) and cleavage rate was calculated. The embryos grading was evaluated according to their morphology and percentage of fragmentation. The biochemical pregnancies was confirm on the fourteenth day of embryo transfer by measurement of serum human chorionic gonadotrophine (B-HCG). Out of the 75 included patients, 15 (20%) achieved pregnancy after ICSI. Pregnant women were associated (P < 0.05). Total oocyte retrieved , stage metaphase II oocyte , pronucleus , cleavage rate , grade I ,total number of embryos ,and number of transferred embryo significantly higher in pregnant women when compared with non-pregnant women(P<0.05) Analysis of ROC curve revealed that area under the curve for number of grade I embryos was 0.868 for predicting pregnancy followed by followed by MII (0.815), number of total oocyte .retrieved and PN (0.773), ET(0.767) and total number of embryos(0.758) respectively. Data show that the number of grade I embryos is the better at predicting for successful pregnancy outcome.(higher test result give more positive test).
Asian Journal of Andrology, 2005
Aim: To evaluate the fertilization competence of spermatozoa from ejaculates and testicle when the oocytes were matured in vitro following intracytoplasmic sperm injection (ICSI). Methods: Fifty-six completed cycles in 46 women with polycystic ovarian syndrome were grouped according to the semen parameters of their male partners. Group 1 was 47 cycles that presented motile and normal morphology spermatozoa in ejaculates and Group 2 was the other nine cycles where male partners were diagnosed as obstructive azoospermia and spermatozoa could only be found in testicular tissue fragment. All female patients received minimal stimulation with gonadotropin. Immature oocytes were matured in vitro and inseminated by ICSI. The spermatozoa from testes were retrieved by testicular fine needle aspiration. Results: A total of 449 and 78 immature oocytes were collected and cultured for 48 hours, 75.5 % (339/449) and 84.6 % (66/78) oocytes were matured in Groups 1 and 2, respectively. The percentage of oocytes achieving normal fertilization was significantly higher in Group 1 than that in Group 2 (72.9 % vs. 54.5 %, P < 0.05). There were no significant differences in the rates of oocytes cleavage and clinical pregnancies in these two groups [87.4 % (216/247) vs. 88.9 % (32/36); 21.3 % (10/47) vs. 44.4 % (4/9)]. A total of 15 babies in the two groups were healthy delivered at term. Conclusion: It appears that IVM combined with ICSI using testicular spermatozoa can produce healthy infants, while the normal fertilization rate of in vitro matured oocytes after ICSI using testicular spermatozoa was significantly lower than using the ejaculated spermatozoa.
Sperm morphology: classification drift over time and clinical implications
Fertility and Sterility, 2011
Objective: To assess sperm morphology with Tygerberg (strict) and World Health Organization (WHO) 3rd criteria for intrauterine inseminations (IUI) between two eras to determine if there was a difference in pregnancy rates. Design: Retrospective study. Setting: Academic institution. Patient(s): 127 couples with 290 IUI treatments during 1996-97 (era 1) and 133 couples with 317 IUI treatments during 2005-06 (era 2). Intervention(s): None. Main Outcome Measure(s): Pregnancy rates per cycle and couple. Result(s): Average sperm morphology was higher in era 1 than era 2 for both WHO 3rd (37 AE 13% vs. 23 AE 10%) and strict criteria (8.0 AE 5.0% vs. 4.0 AE 3.0%). Pregnancy rates per cycle were 5.9% versus 19.8% in era 1 and 16.7% versus 19.3% in era 2 for couples with WHO 3rd morphology <30% or R30%, respectively. Pregnancy rates per cycle were 2.7% versus 15.0% in era 1 and 13.3% versus 14.7% in era 2 for couples with strict morphology % 4% or >4%, respectively. Conclusion(s): There was a strong relationship between morphology and IUI outcome in era 1 that was not present in era 2. These results suggest that classification drift increased the percentage of men diagnosed with teratozoospermia and resulted in a loss of predictive value. (Fertil Steril Ò 2011;96:1350-4.
2020
Since the introduction of intracytoplasmic sperm injection (ICSI), the importance of sperm morphology assessment has been given attention in the assisted reproduction field. It is important to select a good-quality motile spermatozoon for giving a better embryo quality in assisted reproduction technique (ART). In ICSI, sperm morphology evaluation is limited due to its low magnification. However, by using intracytoplasmic morphologically selected sperm injection (IMSI), the selection is done at high magnification of ×6600 using motile sperm organelle morphology examination (MSOME). Therefore, it becomes possible to select a good quality spermatozoon with an intact nucleus that may enhance the pregnancy outcomes. Although all patients can benefit from IMSI, it is important to standardize which techniques (IMSI or ICSI) could be used or which group of patients benefit from IMSI to maximize the efficiency of this advanced technology.
Journal of Assisted Reproduction and Genetics, 2015
Purpose To compare the outcomes of ICSI and IMSI in women presenting with poor ovarian response. Methods Data of IMSI cycles performed from January 2011 to December 2013 were included in this retrospective cohort study. Patients were divided into two groups: normoresponder patients (NR group; patients with>4 oocytes retrieved) and poor-responder patients (PR group; patients with≤4 oocytes retrieved). Patients who underwent IMSI were matched with patients who underwent ICSI in the same period. The ICSI and IMSI outcomes were compared in the NR and PR groups. Results A total of 414 matched cycles were included in this study. The NR group comprised 324 cycles (164 ICSI and 160 IMSI cycles), and the PR group comprised 90 cycles (43 ICSI and 47 IMSI cycles). In the NR group, no significant differences were observed between the ICSI-and IMSI-treated couples regarding cycle outcomes. In the PR group, fertilisation rate was significantly lower in IMSI-treated couples (53.9 %± 36.7 % vs. 79.8 %±29.3 %). The proportion of cycles with embryo transfer (57.4 vs. 79.1 %) and the number of transferred embryos (1.5±0.8 vs. 1.9±0.7) were significantly lower in IMSI compared with ICSI. Implantation, pregnancy and miscarriage rates were similar when ICSI or IMSI were performed. Conclusions Our results suggest that unselected couples undergoing ICSI that present with poor ovarian response to controlled ovarian stimulation do not benefit from sperm selection under high magnification prior to ICSI. Keywords Embryo. ICSI. IMSI. Oocyte. Poor responder Capsule Unselected couples undergoing ICSI that present with poor ovarian response to controlled ovarian stimulation do not benefit from sperm selection under high magnification.