Outcomes of Hyaluronic Acid and HOS Test on Sperm Selection for Intracytoplasmic Sperm Injection: A Comparative Study

Abstract

Background: The outcome of intracytoplasmic sperm injection (ICSI) and embryo development are significantly influenced by sperm quality. Objective:The aim of the present study is to find the different outcomes of ICSI by using hyaluronic acid (HA) and hypo-osmotic swelling (HOS) test in sperm selection so as to obtain the best results of ICSI outcomes and the best embryos with high quality to increase pregnancy rate in cases of infertility. Patients and Methods: This study was carried out on 100 patients in ICSI cycles with confirmed diagnosis with unexplained infertility or repeated failure of ICSI cycles, and patients with HOS test positive semen profile. Statistics have been made for the study results. Results: There was significant difference between the HOS and HA groups regarding the fertilization rates, cleavage stage, and blastulation quality (63.7% VS 85.9%; 54.3% VS 80.7% and 50.8% VS 66.6% respectively). However, no statistically significant difference was found between the HOS and HA groups regarding oocytes injected (6.46 % VS 6.56%; P =0.870). They were almost equal in number in ICSI, to avoid any factors which may affect the results. Conclusion: HA could be thought of as the best routine on a regular basis for sperm selection before ICSI. Finally, we have achieved our main goal from the study, which is getting the best protocol for sperm selection in ICSI, which gives the best embryos quality for embryo transfer and increase pregnancy rate in cases of infertility.