Effect of early cumulus cells removal and early rescue ICSI on pregnancy outcomes in high-risk patients of fertilization failure

He, Yuxia; Liu, Haiying; Zheng, Haiyan; Li, Li; Fu, Xin; Liu, Jianqiao

doi:10.1080/09513590.2018.1433159

Cited by 28 publications

(25 citation statements)

References 36 publications

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“…The baseline characteristics, AE result, and fertilization rate for the couples included in the analysis are described in Table 1 . The sample size retrieved ( n = 737) for this retrospective study was greater than the calculated values (334–687) for cohort study by Epi Info version 7.2 for Windows ( https://www.cdc.gov/epiinfo/pc.html ), with two-sided confidence level set at 95%, power set at 90%, ratio (unexposed: exposed) set at 0.1945 (120/617), and the % outcomes in unexposed group set at 5–10% (i.e., the occurrence of total fertilization failure [TFF, FR = 0%] described previously [ 62 ]. The median and interquartile range obtained for AE levels was 13.78 μIU/10 6 spermatozoa (12.12 μIU/10 6 spermatozoa).…”

Section: Resultsmentioning

confidence: 99%

Human sperm acrosome function assays are predictive of fertilization rate in vitro: a retrospective cohort study and meta-analysis

Gang-gang

Zhu

et al. 2018

Reprod Biol Endocrinol

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ObjectiveTo determine whether acrosome function scoring—including acrosomal enzyme (AE) levels and acrosome reaction (AR) results—can predict fertilization rate in vitro.MethodsWe examined the predictive value of acrosomal enzymes (AE) determined by spectrophotometry/N-α-benzoyl-dl-arginine-p-nitroanilide for fertilization rate (FR) in vitro in a retrospective cohort study of 737 infertile couples undergoing IVF therapy. Additionally, a meta-analysis was done for prospective cohort or case-control studies; the following summary measures were reported to expand upon the findings: pooled spearman correlation coefficient (Rs), standardized mean difference (SMD), sensitivity (SEN), specificity (SPE), positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic score (DS), diagnostic odds ratio (DOR), and area under the summary receiver operating characteristic curve (AUC).ResultsLower AE levels determined by spectrophotometry with a cut-off value of <25μIU/106 spermatozoa were predictive of total fertilization failure (TFF) with moderate SEN (88.23%) and low SPE (16.50%). On meta-analysis, a total of 44 unique articles were selected, but given the multiple techniques described there was a total of 67 total datasets extracted from these 44 articles, comprising 5356 infertile couples undergoing IVF therapy. The AE levels or induced AR% was positively correlated with FR (Rs = 0.38, SMD = 0.79; Rs = 0.40, SMD = 0.86, respectively). Lower AE levels or induced AR% was predictive of lower fertilization rate with moderate accuracy (AUC = 0.78, AUC = 0.84, respectively); this was accompanied by low SEN/moderate SPE (0.57/0.85), moderate SEN/moderate SPE (0.79/0.87), respectively. For AE assay, the diagnostic performance in Asia (Rs = 0.24, SMD = 0.50) was inferior to that in North America (Rs = 0.54, SMD = 0.81) and Europe (Rs = 0.46, SMD = 0.92). Cryopreserved spermatozoa (SMD = 0.20, P = 0.204) were inferior to fresh spermatozoa (SMD = 0.89, P < 0.001). Sperm preparation yielded inferior results as compared to no preparation; spermatozoa after swim up were weak relevant (Rs = 0.27, P = 0.044); and there was no correlation for spermatozoa after a discontinuous gradient (SMD = 1.07, P > 0.05). Lower AE levels determined by fluorometry or substrate assay were used for predicting lower FR with low sensitivity and high specificity; the spectrophotometry assay had an uncertain predictive value. For induced AR assay, the diagnostic performance in the other areas was inferior to that in Africa (Rs = 0.65, SMD = 1.86). No preparation or double preparation yielded inferior results as compared to one preparation (Rs = 0.41); discontinuous gradient (Rs = 0.17, SMD = 0.47) was inferior to swim up (Rs =0.65, SMD = 1.51). Nonphysiological triggers (SMD = 0.81) did not differ from physiological triggers (SMD = 0.95) in general; ZP (Rs = 0.63) or mannose (Rs = 0.59) was superior to other physiological or nonphysiological triggers; and there was no correlation for human follicle fluid, progesterone, cyclic adenosine 3′-5′-p...

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Section: Resultsmentioning

confidence: 99%

Human sperm acrosome function assays are predictive of fertilization rate in vitro: a retrospective cohort study and meta-analysis

Gang-gang

Zhu

et al. 2018

Reprod Biol Endocrinol

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“…Li, Wang, Li, and Shi (2017) reported that the clinical outcomes of RICSI cycles were not significantly affected in the NSMR <4% group compared with those in the NSMR ≥4% group. Moreover, early RICSI did not have detrimental effects on clinical or neonatal outcomes compared with c‐IVF/ICSI (Chen et al, 2014; He et al, 2018). In the present retrospective study, complete fertilisation failure cycles were resolved by early RICSI, and good clinical outcomes were obtained (Table 4), which was consistent with the studies mentioned above.…”

Section: Discussionmentioning

confidence: 99%

Effects of the normal sperm morphology rate on the clinical and neonatal outcomes of conventional IVF cycles

Chen

Liu

et al. 2020

Andrologia

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The present study assessed the influences of the normal sperm morphology rate on the clinical and neonatal outcomes of conventional in vitro fertilisation cycles. This retrospective study analysed 427 and 2,728 cycles from the normal sperm morphology rate <4% and ≥4% group respectively. The clinical (total fertilisation failure, clinical pregnancy, implantation and abortion) and neonatal (sex, gestational age, preterm birth, birthweight, low birth weight, live births and birth defects of newborns) outcomes were compared. The rate of total fertilisation failure in the normal sperm morphology rate <4% group was significantly higher compared with that in the normal sperm morphology rate ≥4% group (2.8% versus 1.2%, p = .012). Total fertilisation failure was completely resolved by early rescue intracytoplasmic sperm injection. The clinical pregnancy, implantation and abortion rates were not significantly different between the two groups. Additionally, the sex, preterm birth, low birth weight, live births and birth defect rates, gestational age and birthweight of newborns were not significantly different between the two groups. Thus, normal sperm morphology rate <4% significantly increased the total fertilisation failure rate but did not affect the clinical or neonatal outcomes.

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“…However, 4-20% of IVF cycles are associated with total fertilization failure (tFF) [10], adding an emotional and financial burden to an already stressful and expensive treatment plan. As a consequence, rescue ICSI has emerged to reduce the risk of tFF in the current IVF cycle [11].…”

Section: Introductionmentioning

confidence: 99%

“…The unfertilized oocyte was identified by the presence of one PB and rescued with ICSI. It was reported in many studies that early rescue ICSI was superior to the former late approach [11]. In addition to effectively overcoming tFF, early rescue ICSI can save oocytes from a potentially detrimental environment contaminated by metabolic sperm degradation products by terminating sperm and oocyte incubation for the polar body (PB) early check [11].…”

Section: Introductionmentioning

confidence: 99%

“…It was reported in many studies that early rescue ICSI was superior to the former late approach [11]. In addition to effectively overcoming tFF, early rescue ICSI can save oocytes from a potentially detrimental environment contaminated by metabolic sperm degradation products by terminating sperm and oocyte incubation for the polar body (PB) early check [11]. Nevertheless, the outcomes of children born after early rescue ICSI are not well evaluated, mostly because patients who deliver after transferring embryos derived from rescue ICSI are challenging to recruit.…”

Section: Introductionmentioning

confidence: 99%

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Perinatal and neonatal outcomes of pregnancies after early rescue intracytoplasmic sperm injection in women with primary infertility compared with conventional intracytoplasmic sperm injection: a retrospective 6-year study

Xiong

Sun

et al. 2020

BMC Pregnancy Childbirth

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Background: Early rescue intracytoplasmic sperm injection (ICSI) has been used in clinic as appropriate currently. While the outcomes of children born after this method were not well assessed. The purpose of this study was to evaluate the effect of early rescue ICSI on women with primary infertility. Methods: Fresh embryo transfer cycles after rescue (n = 214) and conventional (n = 546) ICSI were retrospectively evaluated from women with primary infertility who underwent their first assisted reproductive technology cycles at our center in 2012-2017. The conventional ICSI group was subdivided into ICSI-1 (semen suitable for in vitro fertilization, IVF) and ICSI-2 (poor semen quality) to minimize bias from differences in semen quality. Pregnancy, delivery and neonatal outcomes were compared between groups. Results: There was a higher rate of polyspermy and a lower rate of top-quality embryos (TQE) on day 3 for oocytes subject to rescue ICSI compared with conventional ICSI. This reduced the total number of TQE and the number of TQE transferred in the rescue ICSI group. There was no significant difference between groups in clinical pregnancy, ongoing pregnancy, early miscarriage and live birth. For pregnant women, gestational age, route of delivery, risk of preterm birth and gestational diabetes mellitus were also comparable. Neonatal outcomes including sex ratio, birth weight, neonatal intensive care unit admission and birth defects were also similar after rescue and conventional ICSI. Moreover, no differences were observed with the different ICSI subgroups. Conclusions: For women with primary infertility who have a high risk of IVF fertilization failure (FF), rescue ICSI provides a safe and efficient alternative to minimize FF after initial IVF, but results in fewer TQE on day 3.

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Effect of early cumulus cells removal and early rescue ICSI on pregnancy outcomes in high-risk patients of fertilization failure

Abstract: The present study indicated that short insemination had no detrimental effects on clinical outcomes in human IVF and could prevent the occurrence of TFF combined with early rescue ICSI for high-risk patients of fertilization failure, which attained acceptable pregnancy outcomes.

Cited by 28 publications

References 36 publications

Human sperm acrosome function assays are predictive of fertilization rate in vitro: a retrospective cohort study and meta-analysis

Human sperm acrosome function assays are predictive of fertilization rate in vitro: a retrospective cohort study and meta-analysis

Effects of the normal sperm morphology rate on the clinical and neonatal outcomes of conventional IVF cycles

Perinatal and neonatal outcomes of pregnancies after early rescue intracytoplasmic sperm injection in women with primary infertility compared with conventional intracytoplasmic sperm injection: a retrospective 6-year study

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