Does the presence of nuclear vacuoles in human sperm selected for ICSI affect pregnancy outcome?

Purpose Various time-lapse studies have postulated embryo selection criteria based on early morphokinetic markers. However, late paternal effects are mostly not visible before embryonic genome activation. The primary objective of this retrospective study was to investigate whether those early morphokinetic algorithms investigated by time-lapse imaging are reliable enough to allow for the accurate selection of those embryos that develop into blastocysts, while of course taking into account the correlation with the type of injected spermatozoa. Methods During a period of 18 months, a total of 461 MII oocytes from 43 couples with severe male factor infertility and previous Bexternal^IVF failures after cleavage-stage embryo transfer (ET) were fertilized by intracytoplasmic morphologically selected sperm injection (IMSI). Thereof, 373 embryos were monitored in a time-lapse incubator until ET on day 5. Blastocyst outcome in combination with three previously postulated MKc (cc2: t3-t2, 5-12 h; t3, 35-40 h; t5, 48-56 h) and the morphology of the selected sperm were analyzed. Results A significant increase in the rate of blastocysts (54.0 vs. 36.3 %; P<0.01) and top blastocysts (25.3 vs. 10.8 %; P<0.001) was observed in the group of those meeting all three morphokinetic criteria (MKc3). However, MKc3 were only met in 23.3 % of all embryos. Moreover, TBR was influenced by the type of injected spermatozoa. In both groups, TBR decreased dramatically (MKc3, 35.0 vs. 17.0 %; MKc<3, 14.2 vs. 8.4 %) when class II/III sperm instead of class I were injected. Conclusion Early morphokinetic parameters might give some predictive information but fail to serve as a feasible selective tool for the prediction of blastocyst development given the influence of the type of spermatozoa injected.

Section: Introductionmentioning

confidence: 99%

The impact of paternal factors on cleavage stage and blastocyst development analyzed by time-lapse imaging—a retrospective observational study

Neyer

Zintz

Stecher

et al. 2015

“…Several studies have reported that the IMSI procedure is positively associated with implantation and pregnancy rates [2][3][4][5][6][7][8][9]. In addition, recent meta-analysis showed that the IMSI procedure is associated with improved embryo quality [10], implantation [10,11] and pregnancy rates [10][11][12], as well as lower miscarriage rates [10,11] in couples with male factor [10][11][12] and previous ICSI failures [10,11].…”

Section: Introductionmentioning

confidence: 99%

Poor-responder patients do not benefit from intracytoplasmic morphologically selected sperm injection

Setti

Braga

Figueira

et al. 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.

“…It enables the accurate, real-time selection of motile "top spermatozoa" with a morphologically and morphometrically normal head [1,4,7]. When available, vacuole-free spermatozoa or spermatozoa presenting a single, small vacuole [6] that occupies less than 4 % of the total head area [10,31] can then be used for intracytoplasmic morphologically selected sperm injection (IMSI) [7]. It has been suggested that in patients with ICSI cycle failures, implantation efficiency and pregnancy rates may be increased by the use of IMSI [1].…”

Section: Introductionmentioning

confidence: 99%

High-magnification sperm selection does not decrease the aneuploidy rate in patients who are heterozygous for reciprocal translocations

Chelli

Ferfouri

Boitrelle

et al. 2013

Problem This study sought to evaluate the value of motile sperm organelle morphology examination (MSOME) for selecting euploid spermatozoa in six patients who were heterozygous for a reciprocal translocation. Method of study We used sperm fluorescence in situ hybridization (FISH) to screen for aneuploidy of the chromosomes involved in the translocations and a putative interchromosomal effect (ICE) for chromosomes 18, X and Y. This procedure was performed on (i) whole sperm (i.e. no selection) and on normal spermatozoa selected (ii) at a magnification typically used for intracytoplasmic sperm injection (ICSI), referred to as "ICSIlike", and (iii) with MSOME. Results The balanced translocation rates did not differ significantly (p=0.81) when comparing whole sperm (57.2 %) with spermatozoa after ICSI-like selection (56.3 %) or after MSOME (53.7 %). Similarly, the aneuploidy rates for ICEs did not differ significantly (p=0.14) when comparing whole sperm (1.9 %), ICSI-selected spermatozoa (3.4 %) and MSOME-selected spermatozoa (1.0 %). Conclusion For patients who are heterozygous for reciprocal translocations, MSOME does not improve the selection of euploid spermatozoa.