Abnormal fertilization in ICSI and its association with abnormal semen parameters

Abstract

Intracytoplasmic sperm injection (ICSI) efficiently addresses male factor infertility. However, the occurrence of abnormal fertilization, mainly characterized by abnormal pronuclei (PN) patterns, merits investigation. To investigate abnormal fertilization patterns following ICSI and identify their respective associations with abnormal parameters in semen analysis (SA), a retrospective observational study including 1855 cycles was performed. Male infertility diagnosis relied on the 2010 WHO criteria. The population was divided into groups based on their SA results. The presence of 2PNs and extrusion of the second polar body (PB) indicated normal fertilization. A Kruskal–Wallis test along with a Wilcoxon post hoc evaluation and Bonferroni correction was employed for comparison among the groups. For the pregnancy rate, logistic regression was employed. No correlation was established between the SA abnormalities and the 1PN or 3PN formation rates. The highest and lowest 0PN rates were reported for the oligoasthenoteratozoospermic and normal groups, respectively. The lowest cleavage formation rates were identified in the oligoasthenozoospermic and oligoasthenoteratozoospermic groups. The aforementioned groups along with the oligoteratozoospermic group similarly presented the lowest blastocyst formation rates. For the clinical pregnancy rate, no statistically significant difference was observed. In conclusion, the incidence of two or more abnormal SA parameters – with the common denominator being oligozoospermia – may jeopardize normal fertilization, cleavage, and blastocyst rates. Once the developmental milestone of achieving blastocyst stage status was achieved, only oligoasthenozoospermia and oligoasthenoteratozoospermia were associated with lower rates. Interestingly, following adjustment for the number of blastocysts, no statistically significant differences were observed.

Effect of three pro-nuclei (3PN) on the outcomes of PGT

“…No correlation was observed between the semen analysis abnormalities and the 3PN formation rates in ICSI [21]. Some studies suggest severe sperm abnormalities and oocyte aging can contribute to the process [4,22].…”

Perspective Chapter: Application of Abnormally Fertilized Eggs and the Associated Clinical Outcomes

“…The semen sample may show a low number of sperm and abnormal morphology, and these sperm are incapable of penetrating the egg's membranes. This is often associated with a high percentage of abnormally shaped sperm (morphology) [20]. In severe cases, sperm abnormality may result in total failure of fertilization.…”

Chromosomal analysis of single sperm cells from infertile couples with severe oligoteratozoospermia: A cross-sectional prospective study

“…Many genetic factors have been implicated in male infertility, and prior studies have consistently demonstrated that individuals experiencing severe oligozoospermia (i.e., low sperm count) and teratozoospermia (i.e., abnormal sperm forms) have a higher incidence of sperm aneuploidy than those with normal semen parameters [8][9][10][11]. Recent observational studies have revealed a possible association between abnormal semen parameters and impaired fertilization rates and embryonic development, even after IVF/ICSI [12]. An emerging concern is the potential link between these conditions and an increased risk of aneuploidy in sperm and embryos.…”