Decreased Sperm Motility Retarded ICSI Fertilization Rate in Severe Oligozoospermia but Good-Quality Embryo Transfer Had Achieved the Prospective Clinical Outcomes

Abstract

IntroductionSpermatozoa motility is the critical parameter to affect the treatment outcomes during assisted reproductive technologies (ART), but its reproductive capability remains a little informed in condition of severe male factor infertility. This retrospective cohort study aimed to evaluate the effects of reduced sperm motility on the embryological and clinical outcomes in intra-cytoplasmic sperm injection (ICSI) treatment of severe oligozoospermia.Patients and Methods966 cycles (812 couples) of severe oligozoospermia diagnosed by spermatozoa count ≤ 5 × 106/mL and motile spermatozoa ≤ 2 × 106/mL were divided into four groups in according to the number of motile spermatozoa in one ejaculate on the day of oocyte retrieval (Group B—E). The control (Group A) was 188 cycles of moderate oligozoospermia with spermatozoa count > 5 × 106/mL and motile spermatozoa > 2 × 106/mL. All female partners were younger than 35 years of age. Logistic regression analyzed embryological outcomes (the rates of fertilization, cleavage and good-quality embryo) and clinical outcomes (the rates of pregnancy, implantation, early miscarriage and live birth). Quality of embryo transfer (ET) was divided into three classes as continuous factor to test the effects of embryo quality on clinical outcomes.ResultsThe reduction in the number of motile sperm in four groups of severe oligozoospermia gave rise to comparable inability of the fertilization (p < 0.001) and a decreased rate of good-quality embryo at Day 3 (p < 0.001) by compared to the control. The cleavage rate of the derived zygotes was similar to the control. ET classes significantly affected the clinical outcomes (p < 0.001). Class I ET gave rise to similar rates of clinical outcomes between five groups, but Class II and Class III ET retarded the rates of pregnancy, implantation and live birth and this particularly occurred in Group C, D and E. The rate of early miscarriage was not comparably different between groups. Overall rates in all groups were 41.26% clinical pregnancy, 25.74% implantation and 36.32% live birth, which gave live birth to 252 girls and 252 boys.ConclusionsThe reduction of motile spermatozoa in severe oligozoospermia decreased the rates of fertilization and good-quality embryo. Obtaining and transfer of good-quality embryos was the good prognostic to achieve prospective clinical outcomes regardless of the severity of oligozoospermia.

How general semen quality influences the blastocyst formation rate: Analysis of 4205 IVF cycles

“…We considered the hypothesis that in ICSI cycles where one spermatozoa with better quality parameters is chosen and injected in the oocyte, the intrinsic quality is still affected by the general semen quality, and it is impossible to tell the best spermatozoa based on the genetic information alone. Therefore, the potential of embryo development is also affected ( Zheng et al ., 2016 ). Based on the group classifications, we evaluated the effects of semen quality on blastocyst development in a large cohort of patients/oocytes.…”

“… Zheng et al (2016) demonstrated that a reduced number of motile spermatozoa diminished fertility and embryo quality on day 3; however, if there was a good embryo for transfer, the likelihoods of implantation and pregnancy were similar. Then, it was suggested that the implantation rate was the important parameter to evaluate the ability of an individual embryo to be implanted and it was not associated with sperm quality ( Zheng et al ., 2016 ). We did not evaluate the clinical outcomes, which is a limitation of this study.…”

“…Extended culture has been the most frequently applied strategy worldwide, especially since recent guidelines have emphasized the single embryo transfer approach ( Maheshwari et al ., 2016 ). Other advantages of extended embryo culture to the blastocyst stage are the possibility of trophectoderm biopsy for genetic analysis, and the time-lapse approach for evaluating embryo development ( Zheng et al ., 2016 ).…”

“…The male factor is present in approximately 50% of the cases, regardless of female factors. Previous studies have shown that sperm motility reduction is a critical parameter that affects fertilization rates, number of embryos developed ( Chapuis et al ., 2017 ) and rate of good quality embryos on day 3 ( Zheng et al ., 2016 ). Additionally, sperm morphology has been associated with top quality embryo rates at the cleavage stage (day 3) ( Meng et al ., 2016 ).…”

Sperm origins and concentration do not impact the clinical outcomes in intracytoplasmic sperm injection cycles

“…Previous studies either focused on the outcomes and safety of ICSI with sperms from different sources 7 8 9 10 11 12 or were solely concerned about the clinical outcomes of oligozoospermia. 13 14 However, there is a lack of conclusive data on ICSI outcomes based on the semen retrieval method and sperm concentration in males with azoospermia to mild oligozoospermia. We retrospectively collected 1201 ICSI cycles performed due to male azoospermia or oligozoospermia in males from January 2015 to December 2015.…”