scholarly journals Intracytoplasmic sperm injection: state of the art in humans

Reproduction ◽  
2017 ◽  
Vol 154 (6) ◽  
pp. F93-F110 ◽  
Author(s):  
G D Palermo ◽  
C L O’Neill ◽  
S Chow ◽  
S Cheung ◽  
A Parrella ◽  
...  

Among infertile couples, 25% involve both male and female factors, while male factor alone accounts for another 25% due to oligo-, astheno-, teratozoospermia, a combination of the three, or even a complete absence of sperm cells in the ejaculate and can lead to a poor prognosis even with the help of assisted reproductive technology (ART). Intracytoplasmic sperm injection (ICSI) has been with us now for a quarter of a century and in spite of the controversy generated since its inception, it remains in the forefront of the techniques utilized in ART. The development of ICSI in 1992 has drastically decreased the impact of male factor, resulting in millions of pregnancies worldwide for couples who, without ICSI, would have had little chance of having their own biological child. This review focuses on the state of the art of ICSI regarding utility of bioassays that evaluate male factor infertility beyond the standard semen analysis and describes the current application and advances in regard to ICSI, particularly the genetic and epigenetic characteristics of spermatozoa and their impact on reproductive outcome.

Author(s):  
Jyoti Garg ◽  
Rachana Meena ◽  
Shailaja Shukla ◽  
Sunita Sharma ◽  
Riva Choudhury

Background: In India, the prevalence of primary infertility ranges from 3.9% to 16.8%. Male factor contributes 40-50% of this. Male factor infertility is indicated by decreased sperm concentration, reduced motility, vitality or abnormal sperm morphology. Semen analysis is the single most important investigation to detect male factor infertility. The aim of this study was to analyse the prevalence of abnormal semen parameters among males in infertile couples and their association with contributing factors.Methods: This cross-sectional hospital-based study was carried out in the Department of Pathology at Lady Hardinge Medical College and Smt. Sucheta Kriplani Hospital. A total of 400 cases were analyzed during a period of 6 months. Detailed history of the couple was taken. Semen analysis was done using automated semen analyzer (SQA-vision) after 3 days of abstinence according to the WHO 5th edition 2010 guidelines. The results were analysed using excel sheet and SPSS software.Results: In the present study, 122 cases (30.5%) out of 400 cases had abnormal semen parameters. Most common abnormality detected was asthenozoospermia (14.3%) followed by oligozoospermia (13.8%), azoospermia (10.5%) and teratozoospermia (10.5%). There was significant association of alcohol intake, obesity and trauma with abnormal semen parameters.Conclusions: Asthenozoospermia was the most common abnormality noted in this study. Lifestyle modifications along with timely medical attention in male partners of infertile couples can improve the semen quality.


2021 ◽  
Vol 10 (12) ◽  
pp. 2616
Author(s):  
Tanya L. Glenn ◽  
Alex M. Kotlyar ◽  
David B. Seifer

Intracytoplasmic sperm injection (ICSI) was originally designed to overcome barriers due to male factor infertility. However, a surveillance study found that ICSI use in non-male factor infertility increased from 15.4% to 66.9% between 1996 and 2012. Numerous studies have investigated fertilization rate, total fertilization failure, and live birth rate per cycle (LBR), comparing the use of ICSI versus conventional in vitro fertilization (IVF) for non-male factor infertility. The overwhelming conclusion shows no increase in fertilization rate or LBR per cycle with the use of ICSI for non-male factor infertility. The overuse of ICSI is likely related to the desire to avoid a higher rate of total fertilization failure in IVF. However, data supporting the benefit of using ICSI for non-male factor infertility is lacking, and 33 couples would need to be treated with ICSI unnecessarily to avoid one case of total fertilization failure. Such practice increases the cost to the patient, increases the burden on embryologist’s time, and is a misapplication of resources. Additionally, there remains conflicting data regarding the safety of offspring conceived by ICSI and potential damage to the oocyte. Thus, the use of ICSI should be limited to those with male factor infertility or a history of total fertilization factor infertility due to uncertainties of potential adverse impact and lack of proven benefit in non-male factor infertility.


2015 ◽  
Vol 6 (3) ◽  
pp. 122-127
Author(s):  
K Muthukumar ◽  
TK Aleyamma ◽  
PR Preetha

ABSTRACT Aim The aim of this study was to evaluate the influence of spermatozoa morphology on ICSI cycle outcome parameters in couples with male factor infertility. Design Retrospective study. Setting University-level tertiary care center. Patients and methods One hundred and forty-eight couples with male factor infertility who had undergone intracytoplasmic sperm injection (ICSI) cycle from 2010 to December 2012 were included in this analysis. The semen samples of the male partners were classified according to the three predictive categories of the Tygerberg strict criteria: excellent prognosis (> 14% morphologically normal spermatozoa), good prognosis (5–14%) and poor prognosis (< 5%). Main outcome measures The primary outcome was the embryo quality rate. Results Patients in the poor prognosis subgroups exhibited deficits in spermatozoa concentration, motility and total motile fraction. The variations in the outcome parameters of fertilization rate, embryo development rate and embryo quality did not correlate with sperm morphology. Conclusion Our study suggests that Kruger's strict morphology criteria of the fresh semen sample is not a good predictor for the ICSI cycle outcome. How to cite this article Preetha RP, Kamath MS, Aleyamma TK, Muthukumar K. Influence of Sperm Morphology on the Outcome of Assisted Reproductive Technique-Intracytoplasmic Sperm Injection Cycles: A Retrospective Analysis. Int J Infertil Fetal Med 2015;6(3):122-127.


2013 ◽  
Vol 2013 ◽  
pp. 1-6 ◽  
Author(s):  
May Y. W. Wong ◽  
William L. Ledger

As assisted reproductive technology (ART) methods become the mainstream of infertility treatment, it has become even more critical to reassess its safety. Following the results of a study published by the Robinson Institute in the New England Journal of Medicine, the risk of ART, especially intracytoplasmic sperm injection (ICSI), has never been so closely scrutinized. This paper traces the origins and development of ICSI, assesses the risks documented in the literature, and finally interprets the implications of the study for couples contemplating therapy. We support the need for continued vigilance towards ICSI and the importance in investigating male-factor infertility as a prequel to its use.


2012 ◽  
Vol 2012 ◽  
pp. 1-7 ◽  
Author(s):  
Catherine Patrat ◽  
Aida Kaffel ◽  
Lucie Delaroche ◽  
Juliette Guibert ◽  
Pierre Jouannet ◽  
...  

Objectives. To analyze the impact of oocyte denudation and microinjection timings on intracytoplasmic sperm injection (ICSI) outcomes.Study Design. We included ICSI cycles with the following parameters: rank 1 or 2, female age years, male factor infertility, long protocol using GnRH agonist and rFSH for ovarian stimulation, and use of freshly ejaculated sperm (). Several ICSI parameters were analyzed according to the time between oocyte retrieval and denudation () and the time between denudation and ICSI () using a statistical logistic regression analysis.Results. Neither nor had a significant influence on the Metaphase II (MII) rate but the fertilisation rate (FR) showed a significant improvement when was longer (optimal results at hours) while FR significantly decreased with the increase of . Optimal implantation (IR) and pregnancy (PR) rates were obtained when was around 2 hours.Conclusion. Incubation of oocytes around 2 hours between retrieval and denudation may not increase MII rate but appears to lead to the optimal combination of FR and IR.


BMJ Open ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. e051058
Author(s):  
Sine Berntsen ◽  
Bugge Nøhr ◽  
Marie Louise Grøndahl ◽  
Morten Rønn Petersen ◽  
Lars Franch Andersen ◽  
...  

IntroductionOver the last decades, the use of intracytoplasmic sperm injection (ICSI) has increased, even among patients without male factor infertility. The increase has happened even though there is no evidence to support that ICSI results in higher live birth rates compared with conventional in vitro fertilisation (IVF) in cases with nonmale factor infertility. The lack of robust evidence on an advantage of using ICSI over conventional IVF in these patients is problematic since ICSI is more invasive, complex and requires additional resources, time and effort. Therefore, the primary objective of the IVF versus ICSI (INVICSI) study is to determine whether ICSI is superior to standard IVF in patients without severe male factor infertility. The primary outcome measure is first live birth from fresh and frozen-thawed transfers after one stimulated cycle. Secondary outcomes include fertilisation rate, ongoing pregnancy rate, birth weight and congenital anomalies.Methods and analysisThis is a two-armed, multicentre, randomised, controlled trial. In total, 824 couples/women with infertility without severe male factor will be recruited and allocated randomly into two groups (IVF or ICSI) in a 1:1 ratio. Participants will be randomised in variable block sizes and stratified by trial site and age. The main inclusion criteria are (1) no prior IVF/ICSI treatment, (2) male partner sperm with an expected count of minimum 2 million progressive motile spermatozoa following density gradient purification on the day of oocyte pick up and (3) age of the woman between 18 and 42 years.Ethics and disseminationThe study will be performed in accordance with the ethical principles in the Helsinki Declaration. The study is approved by the Scientific Ethical Committee of the Capital Region of Denmark. Study findings will be presented, irrespectively of results at international conferences and submitted for publication in peer-reviewed journals.Trial registration numberNCT04128904. Pre-results.


2019 ◽  
Vol 37 (01) ◽  
pp. 005-011
Author(s):  
Amanda B. Reed-Maldonado ◽  
Kristin C. Madden

AbstractMale infertility is a condition that affects approximately 50% of infertile couples and about 30% of those couples have only male factor infertility identified. There has been speculation that male military service members may have an even greater lifetime prevalence of infertility as compared to the general population, but very few scientific publications focus on male factor infertility in the military population specifically. This review will discuss many of the unique considerations regarding male infertility in the military and highlight future opportunities for research. The military/federal health system has the potential to serve as a leader in both the delivery of health care for male factor infertility and in the clinical investigation into the etiologies of and treatments for male factor infertility.


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