Pregnancy rates are higher with intracytoplasmic morphologically selected sperm injection than with conventional intracytoplasmic injection

Bartoov, Benjamin; Berkovitz, Arie; Eltes, Fina; Kogosovsky, Avraham; Yagoda, Arie; Lederman, Hanna; Artzi, Shira; Gross, Moshe; Barak, Yona

doi:10.1016/j.fertnstert.2003.05.016

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Volume 80, Issue 6 , Pages 1413-1419, December 2003

Pregnancy rates are higher with intracytoplasmic morphologically selected sperm injection than with conventional intracytoplasmic injection

Benjamin Bartoov, Ph.D.
- Male Fertility Laboratory, Faculty of Life Sciences, Bar-Ilan University, Ramat Gan, Israel
- Reprints requests: Prof. Benjamin Bartoov, Male Fertility Laboratory, Faculty of Life Sciences, Bar-Ilan University, Ramat Gan 52900, Israel (FAX: 972-3-5343679).
Arie Berkovitz, M.D.
- IVF Unit, Department of Obstetrics and Gynaecology, Sapir Medical Center, Meir Hospital, Kfar Saba, Israel
Fina Eltes, M.Sc.
- Male Fertility Laboratory, Faculty of Life Sciences, Bar-Ilan University, Ramat Gan, Israel
Avraham Kogosovsky, M.D.
- IVF Unit, Herzliya Medical Center, Herzliya-on-the-Sea, Israel
Arie Yagoda, M.D.
- Women's Health Centre, Kupat Holim Leumit, Israel
Hanna Lederman, M.Sc.
- Male Fertility Laboratory, Faculty of Life Sciences, Bar-Ilan University, Ramat Gan, Israel
Shira Artzi, M.Sc.
- IVF Unit, Herzliya Medical Center, Herzliya-on-the-Sea, Israel
Moshe Gross, M.D.
- Women's Health Centre, Kupat Holim Leumit, Israel
Yona Barak, Ph.D.
- IVF Unit, Herzliya Medical Center, Herzliya-on-the-Sea, Israel

Received 12 December 2002; received in revised form 1 May 2003; accepted 1 May 2003.

Abstract

Objective

To verify whether microinjection into retrieved oocytes of motile spermatozoa with morphologically normal nuclei, strictly defined by high power light microscopy (× >6000), improves the IVF/intracytoplasmic sperm injection (ICSI) pregnancy rate in couples with repeated ICSI failures.

Design

Comparative prospective study testing routine IVF/ICSI outcome parameters against those of modified ICSI based on morphological selection of spermatozoa with normal nuclei.

Setting

Male factor fertility laboratory and IVF center.

Patient(s)

Sixty-two couples, with at least two previous consequent pregnancy failed ICSI cycles, underwent a single ICSI trial preceded by morphological selection of spermatozoa with normal nuclei. Fifty of these couples were matched with couples who underwent a routine ICSI procedure at the same IVF center and exhibited the same number of previous ICSI failures.

Intervention(s)

Standard ICSI and modified ICSI.

Main outcome measure(s)

ICSI pregnancy rate.

Result(s)

The matching study revealed that pregnancy rate after modified ICSI was significantly higher than that of the routine ICSI procedure (66.0% vs. 30.0%).

Conclusion(s)

Microinjection into retrieved oocytes of selected spermatozoa with strictly defined morphologically normal nuclei improves significantly the incidence of pregnancy in couples with previous ICSI failures.

Keywords: IVF/ICSI, pregnancy rate, sperm morphological selection, sperm nucleus, male fertility