Study Of Sperm Quality Related Factors On The Outcomes Of ICSI For Infertility Patients

Objectives: The study analyzed four factors that can affect sperm quality whichincluded male chromosome polymorphism, smoking, varicocele and sperm for ICSIsources. These four factors’ influence on the outcomes of ICSI was studied, in order toprovide basic counseling for couples who will do ICSI.Methods: The patients were the first cycle couples to receive ICSI treatment.Known factors which may affect the woman’s egg quality and embryo implantationwere exclued, such as polycystic ovary syndrome, ovarian reserve dysfunction,uterine fibroids, hyperprolactinemia, endometriosis and pelvic adhesions.200patientsselected for male factor couple initially met the inclusion criteria. For univariateanalysis, this study conducted a second round of screening to eliminate interferencefrom other factors. In males, the following were identified;15cases of chromosomalpolymorphism,17cases of smoking,17cases of varicocele,30cases with testicularsperm source and40patients with epididymal sperm source. The corresponding indexover the same period was selected, among those normal male patients doing ICSIwere selected as the control group, specifically:15cases of non-chromosomalpolymorphism man,17cases of non-smoking man,17cases of without varicoceleman and84cases using ejaculated sperm. Women were using conventional ovulationinduction, embryo culture using sequential culture method. Gamete, embryo andpregnancy datas were recorded. SPSS17.0software was used for statistical analysis.Results are as follows:1. Embryo development and pregnancy outcomes of male chromosomepolymorphism patients doing ICSI compared with the control group: thefertilization rate, biochemical pregnancy and clinical pregnancy rates were notstatistically different (P＞0.05) and results were74.26%vs76.51%;70.59%vs 66.27%;99.01%vs99.09%;100.00%vs99.09%;44.79vs49.09%;34.78vs31.82%;0.00%vs13.33%; respectively.2. Embryo development and pregnancy outcomes of smoking patients doing ICSIwas compared with the control group: smoking fertilization rate was74.85%which was significantly lower than the control group with86.22%fertilizationrate (P=0.006), smoking group2PN fertilization rate was significantly lower thanthe control group (P=0.034), with values67.66%vs77.55%. Cleavage ratesbetween the two groups,2PN cleavage rate, and these were96.80%vs98.22%;98.23%vs99.34%;47.79%vs50.66%;45.24%vs41.51%;11.76%vs5.88%;58.82%vs64.71%respectively.3. Embryo development and pregnancy outcomes of patients with varicocelecompared with the control group: the blastocyst formation rate in varicocele groupwas significantly lower than the control group (P=0.041), which was22.58%vs47.37%. Fertilization rates between the two groups,2PN fertilizationrate, biochemical pregnancy and clinical pregnancy rates were not statisticallydifferent (P＞0.05) and were76.54%vs75.41%;69.83%vs65.57%;94.89%vs96.38%;95.20%vs97.50%;50.40%vs46.67%;52.94%vs58.82%respectively.4. For testicular sperm group;2PN fertilization rate and embryo quality wassignificantly lower than sperm injection group and results were68.08%vs80.80%,P=0.000;61.24%vs72.79%, P=0.000and38.83%vs50.97%, P=0.004. Cleavagerate of testicular sperm group; blastocyst formation rate and clinical pregnancyrate compared with sperm injection group, had no significant difference (P＞0.05),96.65%vs96.50%;96.81%vs97.57%;40.45vs45.63%;56.67%vs61.90%respectively.5. Epididymal sperm group; good quality embryo, blastocyst formation rate andclinical pregnancy rate compared with sperm injection group did not show anysignificant difference (P＞0.05),80.25%vs80.80%;72.00%vs72.79%;98.44%vs96.5%;98.61%vs97.57%;50.69%vs50.97%;55.41%vs45.63%;57.50%vs61.90%respectively. 6. Fertilization rates of testicular sperm group,2PN fertilization rate and embryoquality was significantly lower than epididymal sperm group and were68.08%vs80.25%;61.24%vs72.00%and38.83%vs50.69%with P＜0.05. The testicularsperm group,2PN cleavage rate, cleavage rate, blastocyst formation rate andclinical pregnancy rate, compared with the epididymal sperm group had nostatistical difference,96.65%vs98.44%respectively;96.81%vs98.61vs55.41%%vs40.45and70.00%vs57.50%,(P＞0.05).Conclusions:1. A male chromosome polymorphism does not affect the line of ICSI embryos andpregnancy outcome, hence while doing ICSI we do not have to consider thechromosome polymorphism in men.2. Male smoking affects the fertilization rate. and for successful embryo transfer andhence implantation, quitting smoking is obvoiusly beneficial before doing ICSI.3. Men having varicocele undergoing ICSI have reduced blastocyst formation rate,varicocele should be treated as soon as possible before doing ICSI.4. The testicular and epididymis sperm line ICSI assisted did not differ between theclinical pregnancy rates. However, in order to increase the number of availableembryos and periodic cumulative pregnancy rate, priority epididymal sperm.