The Impact Of Sperm Source And Parameter On The Outcome Of ICSI

Objective:To evaluate the impact of sperm source and sperm parameter on the outcomes of intracytoplasmic sperm injection(ICSI).Materials and Methods:This retrospective study included 433 ICSI cycles from May.2005 to Dec.2008 in Reproductive Medical Center of XiangYa Hospital.The patients were divided into two major groups according to the source of spermatozoa used for ICSI:1) Ejaculated (group A;n = 336) and 2) Epididymal(group B;n = 97).Group A was subdivided into three subgroups according to the sperm parameter:1) Normal(group A1;n=95);2)single parameter defect(group A2;n = 119); 3) multiple parameter defect(groupA3;n = 122).Result:1.The female age,infertile period,rate of normal female,E₂ peak in day of HCG injected,endometrial thickness in day of HCG injected, rate of type A endometrial in day of HCG injected,number of transferred embryos have no statistic difference(P＞0.05)2.The fertilization rate is 82.11%in group A1,80.10%in group A2,80.29%in group A3,and 80.44%in group B.The difference is not significant(P＞0.05)3.The normal fertilization rate is 72.28%in group A1,76.14%in group A2,73.96%in group A3,and 75.96%in group B.The difference is not significant(P＞0.05)4.The cleaving embryo rate is 87.29%in group A1,87.82%in group A2,87.63%in group A3,and 85.25%in group B.The difference is not significant(P＞0.05) 5.The good quality embryo rate is 65.36%in group A1,68.00%in group A2,63.33%in group A3,and 63.80%in group B.The difference is not significant(P＞0.05)6.The implanted rate is 21.98%in group A1,21.95%in group A2, 22.69%in group A3,and 22.38%in group B.The difference is not significant(P＞0.05)7.The clinical pregnancy rate is 33.68%in group A1,36.97%in group A2,34.43%in group A3,and 35.05%in group B.The difference is not significant(P＞0.05)8.The early abortion rate is 9.47%in group A1,9.24%in group A2, 9.84%in group A3,and 9.28%in group B.The difference is not significant(P＞0.05).Conclution:1.The outcome is similar no matter that the spermatozoa is from ejaculated sperm or epididymis.2.ICSI can treat male infertility of various factors,and the outcome is no matter with one or multiple sperm parameter abnormality.3.ICSI with epididymal spermatozoa according to percutaneous epididymal sperm aspiration is an efficient treatment of infertility result from OA.