Use of a medium buffered with N-hydroxyethylpiperazine-N-ethanesulfonate (HEPES) in intracytoplasmic sperm injection procedures is detrimental to the outcome of in vitro fertlization

Morgia, Francesco; Torti, Monica; Montigiani, Monica; Piscitelli, Claudio; Giallonardo, Annalise; Schimberni, Mauro; Giannini, Pierluigi; Sbracia, Marco

doi:10.1016/j.fertnstert.2005.10.050

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Volume 85, Issue 5 , Pages 1415-1419, May 2006

Use of a medium buffered with N-hydroxyethylpiperazine-N-ethanesulfonate (HEPES) in intracytoplasmic sperm injection procedures is detrimental to the outcome of in vitro fertlization

Francesco Morgia, B.S.
- Bioroma, Center of Assisted Reproduction, “Paideia” Hospital, Rome, Italy
Monica Torti, B.S.
- Bioroma, Center of Assisted Reproduction, “Paideia” Hospital, Rome, Italy
Monica Montigiani, B.S.
- Bioroma, Center of Assisted Reproduction, “Paideia” Hospital, Rome, Italy
Claudio Piscitelli, M.D.
- Bioroma, Center of Assisted Reproduction, “Paideia” Hospital, Rome, Italy
Annalise Giallonardo, M.D.
- Bioroma, Center of Assisted Reproduction, “Paideia” Hospital, Rome, Italy
Mauro Schimberni, M.D.
- Bioroma, Center of Assisted Reproduction, “Paideia” Hospital, Rome, Italy
Pierluigi Giannini, M.D.
- Bioroma, Center of Assisted Reproduction, “Paideia” Hospital, Rome, Italy
Marco Sbracia, M.D.
- Center of Endocrinology and Reproductive Medicine, Rome, Italy
- Reprint requests: Marco Sbracia, M.D., Center for Endocrinology and Reproductive Medicine, Via Carlo Porta 10, 00153, Rome, Italy (FAX: 39-06-5880096)

Received 23 June 2005; received in revised form 25 October 2005; accepted 25 October 2005. published online 04 April 2006.

Objective

This study was conducted to determine whether N-hydroxyethylpiperazine-N-ethanesulfonate (HEPES)–buffered medium used for the microinjection of sperm into oocytes may be detrimental for the embryo.

Design

Controlled randomized study.

Setting

Private IVF center.

Patient(s)

Women (n = 708) undergoing ICSI.

Intervention(s)

The women were randomized into two study groups: 2,204 oocytes from 357 women were treated using a medium buffered with bicarbonate without HEPES during the ICSI procedure, and 2,168 oocytes from 351 women were treated using a medium buffered with HEPES during the ICSI procedure.

Main Outcome Measure(s)

Fertilization rate, degeneration rate, triploid rate, cleavage rate, embryo quality, pregnancy rate, implantation rate, and abortion rate.

Result(s)

Oocytes treated with a HEPES-buffered medium showed a statistically significant higher rate of triploid and degenerated oocytes after fertilization with ICSI compared with oocytes treated with a medium without HEPES. The embryos obtained from oocytes microinjected with a HEPES-buffered medium showed a statistically significant higher rate of highly fragmented embryos compared with the controls. Pregnancy rate and implantation rate were statistically significantly lower in the patient group with oocytes treated with the HEPES-buffered medium. The other parameters evaluated did not show any statistically significant differences.

Concluxion(s)

Our study showed that the use of media buffered with HEPES, during the microinjection of sperm into the oocytes, is detrimental for IVF outcome and should be avoided.

Key Words: HEPES , intracytoplasmic sperm injection , IVF outcome , embryo quality