Assessment of acrosome and nuclear abnormalities in human spermatozoa with large vacuoles

Purpose To evaluate the relationship between oocyte dysmorphisms and IMSI outcomes Methods Data of IMSI cycles performed in 332 patients were included in this study. Patients were included only if presented more than four and less than 30 oocytes upon oocyte retrieval. Patients who underwent IMSI were matched, concerning female age and sperm parameters, with patients who underwent ICSI in the same period (n0332). The two groups (ICSI and IMSI) were compared with regard to treatment outcomes. The influence of IMSI on fertilization and embryo quality on D3 and D5, when oocyte dysmorphisms were present was analyzed. Results A total of 6444 oocytes were morphologically evaluated and injected. Regardless of the oocyte quality, IMSI performance was a determinant of the increased odds of development to high quality embryo on D3 (OR: 1.98; CI: 1.54-2.56) and D5 (OR: 3.27; CI: 1.61-6.66). Conclusions The selection of a morphologically normal spermatozoon under high-magnification is associated with increased embryo quality, regardless of the oocyte morphology. The injection of a spermatozoon, selected under highmagnification, into a morphologically normal oocyte leads to the highest probability of developing high quality embryos.

Section: Discussionmentioning

confidence: 99%

“…Perdrix et al [37] demonstrated that sperm vacuoles are exclusively nuclear. The study showed that aneuploidy and chromatin condensation defects were the main alterations observed in spermatozoa presenting large vacuoles.…”

Section: Discussionmentioning

confidence: 99%

The predictive value of high-magnification sperm morphology examination on ICSI outcomes in the presence of oocyte dysmorphisms

Setti

Braga

Figueira

et al. 2012

“…In the first prospective randomized trial [14], the clinical benefit was more significant in patients with two or more previous failed treatment attempts: IMSI resulted in significantly higher clinical pregnancy rates (29.9 vs 12.9 %; P < 0.05). If large vacuoles are linked to chromatin condensation defects, as has been demonstrated by many authors [6,7,15], more rigorous selection of the sperm cell (as few vacuoles as possible) could improve the quality of the sperm injected into the oocyte. In a previous randomized controlled trial, we reported that IMSI yielded no benefit during the first assisted reproductive technique (ART) attempt.…”

Section: Introductionmentioning

confidence: 94%

“…This technique revealed a new morphological criterion in human spermatozoa: the presence of nuclear vacuoles. Several studies have found increased levels of fragmented DNA in spermatozoa with large vacuoles [2][3][4][5], whereas others [6,7] have shown abnormalities of chromatin condensation in such spermatozoa. Although the origin of these vacuoles raises many questions, some strong correlations have been established between the morphology of the spermatozoon, in particular the presence of large vacuoles, and its nuclear quality (degree of chromatin condensation and/or DNA integrity, chromosomal content) [8].…”

Section: Introductionmentioning

confidence: 99%

Intracytoplasmic morphologically selected sperm injection (IMSI) does not improve outcome in patients with two successive IVF-ICSI failures

Gatimel

Parinaud

Léandri

2016

Purpose Assessment of sperm morphology has been reconsidered since 2001 with the development of motile sperm organelle morphology examination (MSOME). This observation technique that combines high magnification microscopy and the Nomarski interference contrast makes it possible to select spermatozoa with as few vacuoles as possible before microinjection into the oocyte (intracytoplasmic morphologically selected sperm injection, IMSI). More than 10 years after the development of IMSI, the indications of the IMSI technique and its ability to increase pregnancy and/ or birthrates (compared with conventional ICSI) are still subject to debate. We aimed to better define the interest of IMSI in the third attempt. Methods We assessed the benefit of IMSI by carrying out a retrospective comparative study between IMSI and conventional ICSI during a third ART attempt. Two hundred sixteen couples with two previous ICSI failures were studied between February 2010 and June 2014. Results IMSI did not significantly improve the clinical outcomes compared with ICSI, either for implantation (12 vs 10 %), clinical pregnancy (23 vs 21 %), or live birth rates (20 vs 19 %).Conclusion This study provides supplementary arguments for not achieving IMSI procedure in the third attempt after two previous ICSI failures.

“…According to the growing body of literature, it is more and more obvious that large vacuoles are a sign of nuclear dysfunction, reflecting a failure of chromatin condensation and packaging [20][21][22][23][24][25][26][27]. It has been reported that the negative impact of large nuclear vacuoles (LNV) is perceptible after the onset of the EGA, leading to reduced blastocyst formation [28][29][30][31].…”

Section: Introductionmentioning

confidence: 99%

The impact of paternal factors on cleavage stage and blastocyst development analyzed by time-lapse imaging—a retrospective observational study

Neyer

Zintz

Stecher

et al. 2015

Purpose Various time-lapse studies have postulated embryo selection criteria based on early morphokinetic markers. However, late paternal effects are mostly not visible before embryonic genome activation. The primary objective of this retrospective study was to investigate whether those early morphokinetic algorithms investigated by time-lapse imaging are reliable enough to allow for the accurate selection of those embryos that develop into blastocysts, while of course taking into account the correlation with the type of injected spermatozoa. Methods During a period of 18 months, a total of 461 MII oocytes from 43 couples with severe male factor infertility and previous Bexternal^IVF failures after cleavage-stage embryo transfer (ET) were fertilized by intracytoplasmic morphologically selected sperm injection (IMSI). Thereof, 373 embryos were monitored in a time-lapse incubator until ET on day 5. Blastocyst outcome in combination with three previously postulated MKc (cc2: t3-t2, 5-12 h; t3, 35-40 h; t5, 48-56 h) and the morphology of the selected sperm were analyzed. Results A significant increase in the rate of blastocysts (54.0 vs. 36.3 %; P<0.01) and top blastocysts (25.3 vs. 10.8 %; P<0.001) was observed in the group of those meeting all three morphokinetic criteria (MKc3). However, MKc3 were only met in 23.3 % of all embryos. Moreover, TBR was influenced by the type of injected spermatozoa. In both groups, TBR decreased dramatically (MKc3, 35.0 vs. 17.0 %; MKc<3, 14.2 vs. 8.4 %) when class II/III sperm instead of class I were injected. Conclusion Early morphokinetic parameters might give some predictive information but fail to serve as a feasible selective tool for the prediction of blastocyst development given the influence of the type of spermatozoa injected.