IVF treatment of moderate male factor infertility: a comparison of mini-Percoll, partial zona dissection and sub-zonal sperm insertion techniques

Abstract

In this study we examined various techniques of in-vitro fertilization (TVF) for treating couples in whom the male had subnormal semen parameters. We compared two sperm preparation methods (mini-Percoll and conventional swimup) for efficiency of recovery after preparation and for fertilization rates after IVF, and compared the suitability of partial zona dissection (PZD) and sub-zonal sperm insertion (SUZI) to patients with different types of male factor infertility. The mini-Percoll technique allowed the recovery of significantly more motile spermatozoa from the same semen sample compared to the swim-up method. More oocytes were fertilized after spermatozoa were prepared by the mini-Percoll technique. An increased number of spermatozoa recovered from an ejaculate led to an improvement in the quality of spermatozoa in the insemination droplet. Subsequently, when using the PZD technique, the fertilization rate increased when there was a higher number of spermatozoa in the patient's ejaculate. When comparing the two micromanipulation techniques, SUZI provided patients with oligoasthenzoospermia (i.e. < 10 x 10 6 spermatozoa/ml and 40% motility) with a higher chance of obtaining 2-pronculeate eggs.

Non-contact microdrilling of mouse zona pellucida with an objective-delivered 1.48-μm diode laser

“…As this radiation is strongly absorbed by water, the delivery of the 2.94-pm radiation could not be performed through a microscope objective and was only possible through an optical fiber brought in immediate contact with the ZP [20]. The first human pregnancies obtained after ZP drilling with this technique have been reported [18,211. Recently, the intracytoplasmic sperm injection (ICSI) using micropipettes has been proposed as an alternative and promising tool in respect to partial zona dissection (PZD) [221 and subzonal insemination (SUZI) [23]. Future safety assessment of these techniques is needed to fully appreciate the advantageddisadvantages of these approaches.…”

Forty years of IVF

“…However, the results were inconsistent, and overall fertilization rates were low in patients without prior IVF cycles. PZD resulted in a rate of polyspermy of up to 57%, as the number of sperm entering the perivitelline space could not be controlled (105,106).…”

“…This enabled the treatment of severe male factor infertility, as well as decreased rates of polyspermy due to control over the number of spermatozoa injected (108). It has been demonstrated that up to four spermatozoa could be injected without increasing the rate of polyspermy, while injection of 5-10 sperm was associated with a 50% rate of polyspermy (106). Initial studies reported fertilization rates of 25%-71% with this technique (107).…”

Effect of different mini‐volume colloid centrifugation configurations on flow cytometrically sorted sperm recovery efficiency and quality using a computer‐assisted semen analyzer

“…The mini‐ (Ord, Patrizio, Marello, Balmaceda, & Asch, ) and continuous‐density centrifugation (Shalika, Dugan, Pelesh, & Padilla, ) methods were originally proposed for poor‐quality sperm samples or samples with a low sperm count. Under those circumstances, the mini‐density gradient (Ng, Liu, & Baker, ; Sakkas et al., ) and single‐layer centrifugation (Abraham, Johannisson, & Morrell, ; Gloria et al., ; Shalika et al., ) procedures recovered significantly more motile, morphologically normal, hypoosmotic swelling test‐resistant spermatozoa in comparison with other sperm separation methods. Therefore, the result of the aforementioned procedures allowed more oocytes to be fertilized per frozen‐thawed straw of semen.…”