The role of sperm aneuploidy as a predictor of the success of intracytoplasmic sperm injection?

Abstract

BACKGROUND: We present the first powered prospective study to assess whether sperm aneuploidy can predict the outcome of ICSI. METHODS: Our null hypothesis was that aneuploidy rates (AR) are identical in men who achieve successful (Group A) and unsuccessful (Group B) ICSI outcome. A power calculation yielded a sample number of 56 to achieve 80% power to reject our hypothesis at the 5% significance level. Samples for testing were obtained on the day of embryo transfer and tests were performed on raw pre-preparation samples. Sperm AR of chromosomes 13, 18, 21, X/Y were assessed using fluorescence in-situ hybridization (FISH) techniques (mean of 1223 sperm). RESULTS: There was no significant difference in any patient, seminal, cycle or laboratory characteristic between groups that may have affected outcome. Total AR (2.37 versus 1.18%, P 5 0.01), as well as AR of chromosomes 18, X/Y and 18 1 X/Y (1.48 versus 0.67%, P 5 0.005) were significantly higher in Group B compared with Group A. Regression analysis confirmed these differences to be independent of other variables and showed a 2.6-fold change in odds of achieving a pregnancy for every 1% change in total AR. CONCLUSIONS: Our findings confirm a potential role for aneuploidy testing in the work-up of ICSI patients as a predictor of success, as well as in future genetic counselling. If confirmed, there may also be a place for a study of preimplantation genetic screening to improve ICSI success in men found to have high AR and ICSI failure.

Chromosomal disorders and male infertility

“…5 and 29). However, emerging data from several studies have demonstrated that higher levels of sperm aneuploidy are also associated with recurrent ICSI failure; 40,41 increased chromosomal abnormalities in embryos; 42 and lower pregnancy rates and live births. 43 These studies taken collectively do not provide direct evidence of the paternal contribution to aneuploidy, but certainly suggest that sperm aneuploidy may play a more significant role in aneuploid conceptions than is currently recognized in the field of reproductive medicine.…”

Genetic counseling for men with recurrent pregnancy loss or recurrent implantation failure due to abnormal sperm chromosomal aneuploidy

“…Recurrent pregnancy loss (RPL), which may be defined as two or more pregnancy losses less than 20 weeks after the last menstrual period, is experienced by 1 to 2 % of women [2,3]. While there are many genetic causes for male factor infertility, for couples who have experienced RPL or repeated in vitro fertilization (IVF) failures, male chromosomal aneuploidy or chromosomal structural aberrations (such as translocation, inversion, and pericentric inversion) are of particular concern [4][5][6][7][8]. Aneuploidy is defined as an abnormal number of chromosomes (too few or too many) in a cell due to abnormal meiosis.…”

Human Male Meiosis and Sperm Aneuploidies

“…The authors found a higher aneuploidy rate in those with unsuccessful ICSI outcome, especially for chromosome 18 and the sex chromosomes (Nicopoullos et al, 2008).…”