PICSI™ vs. ICSI: statistically significant improvement in clinical outcomes in 240 in vitro fertilization (IVF) patients

Worrilow, K.C.; Huynh, H.T.; Bower, J.B.; Anderson, Andrew; Schillings, W.J.; Crain, J.L.

doi:10.1016/j.fertnstert.2007.07.133

Cited by 22 publications

(23 citation statements)

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“…A similar increase in IR, CPR, and lower PLR values was found by Worrilow and colleagues [Worrilow et al 2006;Worrilow et al 2007;Worrilow et al 2012]. Others compared conventional sperm selection and the use of sperm selected from a liquid source of HA and an increased IR was found [Parmegiani et al 2010].…”

Section: Discussionsupporting

confidence: 69%

Is sperm hyaluronic acid binding ability predictive for clinical success of intracytoplasmic sperm injection: PICSI vs. ICSI?

Mokánszki¹,

Tóthné

Bodnár

et al. 2014

Systems Biology in Reproductive Medicine

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Although intracytoplasmic sperm injection (ICSI) is now a widely-used technique, it is still of interest to improve our knowledge as to which is the best spermatozoon to be selected for ICSI. Infertile men have increased risks of producing aneuploid spermatozoa. Using hyaluronic acid (HA)-binding sperm selection may reduce the genetic risks such as chromosomal aberrations of offspring. In the present study we examined the clinical success of ICSI with HA-selected sperm ('physiologic' ICSI, PICSI) compared to conventional ICSI, as well as the necessity to differentiate patients according to the initial HA-binding assay result (HBA score) and whether the sperm concentration or HBA score can provide additional information. We observed a significantly higher fertilization rate (FR) of the PICSI group with 460% HBA, implantation rate (IR) of the PICSI group with 60% HBA, and clinical pregnanacy rate (CPR) in every PICSI group compared to the ICSI groups (p50.01). We also observed a significantly higher life birth rate (LBR) in the PICSI group with 60% HBA compared to ICSI patients with 60% HBA (p50.001). The pregnancy loss rate (PLR) was significanly lower in PICSI patients compared to the ICSI group (p50.0001). The FR, IR, CPR, and LBR of the PICSI group with 550% HBA were significantly higher and the PLR was lower than in the ICSI group with 550% HBA (p50.01). A statistically significant correlation was found between the sperm concentration and the HA-binding capacity (r ¼ 0.62, p50.001). We found a closer relationship between HBA score and FR (r ¼ 0.53, NS) than between sperm concentration and FR (r ¼ 0.14, NS). HBA could be considered for sperm selection prior to ICSI because of its success and apparant ability to reduce genetic complications. However, this must be extended to a larger study.

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Section: Discussionsupporting

confidence: 69%

Is sperm hyaluronic acid binding ability predictive for clinical success of intracytoplasmic sperm injection: PICSI vs. ICSI?

Mokánszki¹,

Tóthné

Bodnár

et al. 2014

Systems Biology in Reproductive Medicine

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“…The same positive trend-when injecting HA-bound spermatozoawas observed by Menezo et al comparing 92 HA-ICSI versus 110 PVP-ICSI treatments [24]. A statistically significant improvement in fertilization rate, embryo quality and a reduction in the number of miscarriages were observed by Worrilow et al performing PICSI ® (MidAtlantic Diagnostic) versus conventional ICSI, in a study of 240 patients [25]. Against this, in two studies with a small number of patients involved [44 patients Van Den Berg et al [21] and 18 patients Sanchez et al [26]] no differences in fertilization [21,26], pregnancy and implantation rates [26] were observed when comparing HA-ICSI to PVP-ICSI.…”

Section: Discussionsupporting

confidence: 65%

Efficiency of hyaluronic acid (HA) sperm selection

Parmegiani

Cognigni

Ciampaglia

et al. 2009

J Assist Reprod Genet

117

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“…It has also been reported that sperm that can bind to HA have a reduced risk of being anueploid [6] or having fragmented DNA [7,8]. Initially, a number of studies have suggested a beneficial effect of HA sperm selection on assisted reproductive technology (ART) outcomes [7][8][9][10][11]. However, recently a large study comparing ICSI using HA and conventional ICSI showed no statistical difference in embryo quality and pregnancy rates [12].…”

Section: Introductionmentioning

confidence: 99%

A prospective randomized study to evaluate the effect of hyaluronic acid sperm selection on the intracytoplasmic sperm injection outcome of patients with unexplained infertility having normal semen parameters

Majumdar

2013

J Assist Reprod Genet

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Purpose Sperm quality plays an important role in determining embryo development and intracytoplasmic sperm injection (ICSI) outcome. Selection of competent sperm based on its ability to bind to hyaluronic acid (HA) has been suggested as one of the methods to assess sperm quality. The aim of the present study was to examine whether injection of HA bound sperm helps in improving outcome in patients undergoing ICSI with unexplained infertility having normal semen parameters. Methods Patients with unexplained infertility having normal semen parameters in accordance with WHO 2010 criterion, undergoing their first IVF-ICSI cycle were enrolled during the course of the study.156 patients were prospectively randomized after oocyte retrieval and were assigned to either the ICSI group, where sperm selection for injection was based on visual assessment, or the PICSI group, where sperm were selected based on their ability to bind to HA. Only fresh embryo transfers were included in the analysis. Results There was no difference in the fertilization rates, number of top quality embryos and clinical pregnancy rates between the ICSI and PICSI groups (65.7 % vs 64.7 %; 45.8 % vs 43.6 % and 35 % vs 35.2 % respectively). However, a higher pregnancy loss rate was observed in the ICSI group (25 % vs 12 %; P =0.227) as compared to the PICSI group, but the difference was not statistically significant. Implantation rates were 22.03 % and 18.84 % in the PICSI and ICSI groups respectively. There were 22 (31 %) live births in the PICSI group and 21(26.3 %) live births in the ICSI group. Conclusions Patients with unexplained infertility having normal semen parameters may constitute a patient group which does not benefit from this sperm selection method. A larger study may be necessary to establish a relationship between PICSI and pregnancy loss rate in patients undergoing IVF with unexplained infertility.

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PICSI™ vs. ICSI: statistically significant improvement in clinical outcomes in 240 in vitro fertilization (IVF) patients

Cited by 22 publications

References 0 publications

Is sperm hyaluronic acid binding ability predictive for clinical success of intracytoplasmic sperm injection: PICSI vs. ICSI?

Is sperm hyaluronic acid binding ability predictive for clinical success of intracytoplasmic sperm injection: PICSI vs. ICSI?

Efficiency of hyaluronic acid (HA) sperm selection

A prospective randomized study to evaluate the effect of hyaluronic acid sperm selection on the intracytoplasmic sperm injection outcome of patients with unexplained infertility having normal semen parameters

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