Hyaluronan-binding system for sperm selection enhances pregnancy rates in ICSI cycles associated with male factor infertility

Abstract

Objectives The aim of the present study was to compare two procedures for sperm selection in ICSI cycles - conventional morphology sperm selection (ICSI-PVP) and chemical selection through Hyaluronan-treated petri dishes (PICSI), when male factor was associated.MethodsThe evaluated parameters were semen quality, fertilization and cleavage rates, chemical and clinical pregnancy rates, as well as abortion rate. Fifty-six ICSI cycles were included in this report, 19 cycles using PICSI and 37 using conventional ICSI.ResultsPICSI and ICSI showed, respectively, the following outcome: fertilization rates 71.93% (123/171) and 64.14% (127/198); cleavage rates 95.12% (117/123) and 95.27% (121/127); chemical pregnancy rates 63.15% (12/19) and 27.03% (10/37); clinical pregnancy rates 42.10% (8/19) and 16.21% (6/37); and abortion rates 33.33% (4/12) and 40.00% (4/10). According to both Fisher's Exact Test and Chi-square Test, chemical pregnancy (p = 0.05) and clinical pregnancy (p = 0.09) rates were significantly higher in the PICSI group. p values ≤ 0.05 were consider statistically significant.ConclusionsThe present data indicates that ICSI cycles that used the PICSI technique had a considerably higher chance (≈5 fold) to achieve pregnancy than those who had sperm selected only by morphology assessment. Teratozoospermic patients were those who benefited most with PICSI. Therefore, the technique should be included in laboratory routine with low cost, avoiding the selection of immature sperm with increased rates of peroxidation and DNA fragmentation. Prospective and randomized studies should be applied to strengthen this suggestion.

An efficiency comparison of different in vitro fertilization methods: IVF, ICSI, and PICSI for embryo development to the blastocyst stage from vitrified porcine immature oocytes

“…According to this, other studies with PICSI fertilization have reported that HA-bound injected sperm increased embryo production in human [ 34 ]. But also, low pregnancy loss, high pregnancy rates [ 77 , 78 ], and high DNA integrity [ 79 ] are obtained by PICSI. Therefore, our results demonstrate that sperm selection with HA improves blastocysts rates not only in control but also in vitrified oocytes.…”

Acrosome reaction and chromatin integrity as additional parameters of semen analysis to predict fertilization and blastocyst rates

“…Recently, new methods are available to improve the quality of the selected spermatozoon, such as hyaluronic acid (HA)-binding sperm selection (PICSI), magnetic-activated cell sorting (MACS) of non-apoptotic spermatozoa, and motile sperm organelle morphology examination (MSOME) techniques [ 4 – 6 ]. PICSI has shown some advantages over IVF and ICSI, such as higher percentage of viable and acrosome reacted cells and higher blastocyst rate in a porcine model [ 4 ]; and in humans, higher fertilization, blastocyst cleavage, and clinical pregnancy rates have been reported using the PICSI method [ 7 ]; however, some of these techniques increase the time of the fertilization procedure, have high costs or fail to determine genetic quality.…”

Sperm selection for assisted reproduction by prior hyaluronan binding: the HABSelect RCT

“…The relatively small sample size may have hindered statistical testing. HABSelect, together with the Worrilow et al 57 and Mokánszki et al 108 studies, and the smaller studies described above, 70,[108][109][110] are therefore either unsupportive or ambiguous with regard to a beneficial effect of PICSI on live birth outcomes, but they are in greater agreement on the reported reduction in miscarriage, one of the most devastating outcomes for an expectant couple.…”

“…In agreement with two earlier studies, 57,108 significantly and substantially reduced miscarriage rates were reported. One small study reported no protective effect 110 and another reported no efficacy with any clinical outcome. 109 Sperm HBS has been reported to be associated with markers of sperm viability, including concentration and motility, 108 as was the case with HABSelect.…”