The Influence Of Intracytoplasmic Morphologically Selected Sperm Injection On The Outcomes Of Assisted Reproductive Technique

PART ONE RELATIONSHIP BETWEEN MOTILE SPERM ORGANELLE MORPHOLOGY EXAMINATION AND THE OUTCOMES OF IN VITRO FERTILIZATIONObjectiveThe aim of the present study was to assess the relationship between the motile sperm organelle morphology examination characteristics and IVF-ICSI outcomes.MethodsSperm organelle morphology examination, performed at high magnification (×6600), was applied to the leftover sperm in70couples referred for IVF treatment and10couples participating in ICSI program. Spearman correlation analysis was used to identify relationships between MSOME characteristics and conventional semen parameters, IVF-ICSI fertilization rates, cleavage rate, transferable embryo rate and good quality embryos rate. The effect of female age, body mass index, number of retrieved oocytes, MSOME and sperm parameters on biochemical pregnancies outcome was analyzed by Logistic regression. Roc curve analysis was used to determine the prognostic accuracy of Logistic regression on biochemical pregnancies outcome.ResultsThere was a significant correlation between MSOME characteristics and sperm Concentration, Forward motility and normal morphology(R=0.332, P<0.05; R=0.445, P<0.05; R=0.421, P<0.05).A statistical relationship was found between IVF transferable embryo rate, good quality embryos rate and MSOME(R=0.264, P<0.05; R=0.298, P <0.05). No significant correlation was observed between MSOME characteristics and fertilization rates, cleavage rate, transferable embryo rate and good quality embryos rate in ICSI group, fertilization rates, cleavage rate in IVF group. The incidence of morphologically normal sperm observed by MSOME and other parameters had no significant effect on biochemical pregnancies outcome. Logistic regression had predictive value for biochemical pregnancies(area under ROC curve:0.8125; optimal sensitivity:35.71%; optimal specificity:92.50%)ConclusionMSOME characteristics correlated significantly with routine sperm parameters and effect on later embryo quality in IVF group. MSOME characteristics combined with other influencing factors have a predictive value for pregnancies outcome. PART TWO DOES intracytoplasmic morphologically selected sperm injection improve the embryo quality in teratozoospermia patients?ObjectiveTO investigate whether intracytoplasmic morphologically selected sperm injection (IMSI) can improve the embryo quality in teratozoospermia patients, we compare the fertilization rate, cleavage rate, good quality embryos rate and transferable embryo rate between IMSI and ICSI.MethodsThe auto-control study include20teratozoospermia patients participating in ICSI program. Sibling oocytes of each couple were randomly assigned to two groups:ICSI group or IMSI group. The fertilization rate, cleavage rate, transferable embryos rate, and top quality embryo rates were compared between the two groups.Results The fertilization rate, cleavage rate, transferable embryos rate, and top quality embryo rates were not significantly different among the two groups (P>0.05).ConclusionIMSI can not improve the embryo quality in teratozoospermia patients. The clinical outcomes of IMSI for teratozoospermia patients remain to be determined.