Effect of sperm selection using hyaluronan on fertilization and quality of cleavage-stage embryos in intracytoplasmic sperm injection (ICSI) cycles of couples with severe teratozoospermia

Abstract

This study aimed to evaluate the effect of hyaluronan-selected/physiological intracytoplasmic sperm injection (PICSI) on fertilization and quality of cleavage-stage embryos in infertile couples with ≤1% of spermatozoa with normal strict morphology (severe teratozoospermia). Seventy-seven couples underwent PICSI between October 2017 and December 2018 (PICSI group), while 75 couples underwent conventional intracytoplasmic sperm injection (ICSI) between January 2016 and September 2017 (ICSI group). Good quality embryos (GQEs) were evaluated based on morphology. Patient and cycle characteristics were comparable between the PICSI and ICSI groups, except for age and anti-Müllerian hormone (AMH) level (38.4 ± 3.9 years vs. 36.3 ± 4.3 years, p = .002 and 2.06 ± 1.99 ng/mL vs. 2.97 ± 3.25 ng/mL, p = .040). The fertilization rate per oocyte inseminated and GQE rate were significantly higher in the PICSI group than in the ICSI group (82.7% vs. 71.7%, p ˂ .001 and 52.8% vs. 34.0%, p ˂ .001). Furthermore, the absence of GQEs was found to be lower in the PICSI group (13.0% vs. 30.7%, p = .008). Multivariate analysis adjusted for age and AMH level identified PICSI as an unfavorable and independent factor for the absence of GQEs (adjusted odds ratio, 0.333; 95% confidence interval, 0.125–0.890). PICSI seems to be superior to ICSI in terms of fertilization and embryo quality in couples with severe teratozoospermia.

摘要

本研究旨在评估透明质酸选择/生理性卵胞浆内单精子注射（PICSI）对1%精子形态正常（严重畸形精子症）的不育夫妇的受精和卵裂期胚胎质量的影响。在2017年10月至2018年12月期间, 77对夫妇接受了PICSI （PICSI组）, 而在2016年1月至2017年9月期间, 75对夫妇接受了传统的胞浆内精子注射（ICSI组）。对优质胚进行形态学鉴定。PICSI组和ICSI组的患者和周期特征具有可比性, 除了年龄和抗苗勒氏管激素（AMH）水平（38.4±3.9岁vs. 36.3±4.3岁, p= .002和2.06±1.99 ng/mL vs. 2.97±3.25 ng/mL, p= .040）。PICSI组的每个卵母细胞受精率和优质胚胎（GQE）率显着高于对照组ICSI组（82.7% vs.71.7%, p<0.001和52.8% vs.34.0%, p<0.001）。此外, PICSI组中GQEs的缺失率较低（13.0%对30.7%, p=0.008）。根据年龄和AMH水平进行调整的多变量分析将PICSI确定为GQEs缺失的独立不利因素（调整优势比, 0.333；95%置信区间, 0.125-0.890）。在严重畸形精子症夫妇中, PICSI在受精和胚胎质量方面优于ICSI。

The Chinese abstracts are translated by Prof. Dr. Xiangyan Ruan and her team: Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing 100026, China.

Keywords:

• Intracytoplasmic sperm injection (ICSI)
• hyaluronic acid
• male infertility
• teratozoospermia
• embryo

Disclosure statement

The authors report no conflict of interest.