This study was conducted to investigate the relationship between sperm DNA fragmentation index (DFI) and the outcomes of in-vitro fertilisation-embryo transfer (IVF-ET) and intracytoplasmic sperm injection (ICSI). Sperm DFI in 116 patients for IVF and 63 patients for ICSI were detected with acridine orange test (AOT), and all the cases were divided into DFI ≤ 30% group and DFI > 30% group according to the DFI value; then, the relationship of DFI with the outcomes of IVF/ICSI were analysed. Both in IVF and ICSI cycles, good embryo rate and spontaneous abortion rate in DFI > 30% group were significantly different from that in DFI ≤ 30% group, meanwhile, the fertilisation rate and cleavage rate were similar in two groups. In ICSI cycles, there was a significantly negative correlation between the DFI value and the rates of embryo implantation and pregnancy; the couples with DFI > 30% had significantly lower embryo implantation rate and pregnancy rate than the ones with DFI ≤ 30%. The receiver operating characteristics curve analysis demonstrated that the DFI value were statistically significant predictors of pregnancy. It is concluded that DNA-damaged sperm could have a potential adverse effect on embryo quality and progression of pregnancy as well as the outcomes of ICSI.

(2015) The effects of fertilization mode, embryo morphology at day 3, and female age on blastocyst formation and the clinical outcomes, Systems Biology in Reproductive Medicine, 61:1, 50-56, DOI: 10.3109/19396368.2014 AbstractThe aim of this study was to evaluate the influence of in vitro fertilization (IVF) versus intracytoplasmic sperm injection (ICSI), fertilization mode embryonic morphology at day 3, and female age on blastocyst development, on the clinical outcomes of pregnancy after blastocyst transfer. A total of 471 cycles were retrospectively investigated. The rates of blastocyst formation and of good blastocyst morphology were higher in IVF than in ICSI cycles but there were no significant differences in the clinical pregnancies or in the miscarriage rates. The rates of formation of blastocyst and of blastocysts with good morphology were significantly higher from good-morphology embryos than from poor-morphology embryos. Nevertheless, 16.9% of the poor-morphology embryos reached the blastocyst stage. The total rates of blastocyst formation, and rates of clinical pregnancy and implantation were statistically similar in the age 535, 35-39, and 439 year groups, although tending to decrease with increasing age. When equal numbers of embryos were transferred on day 3, the rates of clinical pregnancy and implantation after blastocyst transfer were significantly higher in the 535 year age group than in the 35-39 and 439 year age groups, which were not significantly different. The miscarriage rates after embryo or blastocyst transfers were not statistically different in groups of similar age. Therefore, extended embryo culture up to the blastocyst stage could be implemented for women aged younger than 35 years to increase the pregnancy rate. For older women, transfer and vitrification of available embryos at day 3 and extended culture of morphologically poor embryos to the blastocyst stage for cryopreservation may improve the clinical outcome.

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ObjectiveThe aim of this study was to investigate associations between the morphology score of blastocysts and blastocoele re-expansion speed after warming with clinical outcomes, which could assist in making correct and cost-effective decisions regarding the appropriate time to vitrify blastocysts and to transfer vitrified-warmed blastocysts.MethodsA total of 327 vitrified-warmed two-blastocyst transfer cycles in women 38 years old and younger were included in this retrospective study.ResultsThe clinical pregnancy rate (CPR) and implantation rate (IR) of transfers of two good-morphology grade 4 blastocysts vitrified on day 5 (64.1% and 46.8%, respectively) were significantly higher than the CPR and IR associated with the transfers of two good-morphology grade 3 blastocysts vitrified on day 5 (46.7% and 32.2%, respectively). No significant differences were found in the CPR and IR among the transfers of two good-morphology grade 4 blastocysts regardless of the day of cryopreservation. Logistic regression analysis showed that blastocoele re-expansion speed after warming was associated with the CPR.ConclusionThe selection of a good-morphology grade 4 blastocyst to be vitrified could be superior to the choice of a grade 3 blastocyst. Extending the culture of grade 3 blastocysts and freezing grade 4 or higher blastocysts on day 6 could lead to a greater likelihood of pregnancy. Since re-expansion was shown to be a morphological marker of superior blastocyst viability, blastocysts that quickly re-expand after warming should be prioritized for transfer.