“Physiologic ICSI”: Hyaluronic acid (HA) favors selection of spermatozoa without DNA fragmentation and with normal nucleus, resulting in improvement of embryo quality

Parmegiani, Lodovico; Cognigni, Graçiela Estela; Bernardi, Silvia; Troilo, Enzo; Ciampaglia, Walter; Filicori, Marco

doi:10.1016/j.fertnstert.2009.03.033

Cited by 230 publications

(227 citation statements)

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“…In a previous prospective-randomized study, we demonstrated that the injection of HA-bound spermatozoa (HA-ICSI or Physiologic ICSI) improved embryo quality and development, by favouring selection of spermatozoa with normal nucleus and intact DNA [5]. The aim of the present study is to verify the role of HA for sperm selection on a larger number of HA-ICSI treatments.…”

Section: Introductionmentioning

confidence: 82%

“…All patients were informed of the procedure and written consent was obtained from each. In our previous prospective randomized study we compared HA-ICSI to conventional PVP-ICSI [5]; for the HA-CSI procedure spermatozoa were selected for their ability to bind to HA using a HA-containing product (Sperm Slow™, MediCult, Jyllinge, Denmark), whereas for the conventional PVP-ICSI procedure sperm motility was reduced by PVP (PVP Clinical Grade, MediCult). This preliminary study demonstrated that HA sperm selection improved embryo quality when injecting a limited number of oocytes.…”

Section: Patient Populationmentioning

confidence: 99%

“…HA's role as "physiologic selector" is now well recognized also in vitro: it has been demonstrated that spermatozoa able to bind HA in vitro are those that have completed plasma membrane remodelling, cytoplasmic extrusion and nuclear maturation [1][2][3]. Furthermore, these HA-bound spermatozoa show low chromosomal aneuploidies and DNA fragmentation, and good nuclear morphology [4,5]. Thus, HA-sperm selection prior to intracytoplasmic sperm injection (ICSI) helps to optimize the outcome of the treatment, especially when insemination of only a limited number of oocytes is allowed by law [6].…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Efficiency of hyaluronic acid (HA) sperm selection

Parmegiani

Cognigni

Ciampaglia

et al. 2009

J Assist Reprod Genet

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116

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Section: Introductionmentioning

confidence: 82%

Section: Patient Populationmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Efficiency of hyaluronic acid (HA) sperm selection

Parmegiani

Cognigni

Ciampaglia

et al. 2009

J Assist Reprod Genet

Self Cite

116

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“…44 In addition, Parmegiani et al suggest that HA-selected ICSI sperm produce equivalent fertilization rates and good quality embryos compared with visually selected sperm, but may improve live baby rates substantially by decreasing miscarriage rates. 45 One limitation of this sperm selection technique is that because sperm are firmly bound to HA, they must be manually removed and cannot be obtained in suitable numbers for IUI or IVF without ICSI. In addition, substantial clinical trial confirmation of these study findings are lacking, including a precise definition of which patients will benefit most from this technology.…”

Section: Reactive Oxygen Speciesmentioning

confidence: 99%

“…However, this technique, termed PICSI ("Physiological" ICSI), has the potential to mimic sperm selection at the traditional evolutionary level and may improve IVF/ICSI outcomes in selected patients by reducing the abnormal paternal contribution of sperm. 45 Ultrafine Morphology For 20 years, since the first report of a relationship between sperm morphology and IVF outcomes by Kruger,6 the value of sperm morphology as a predictor of pregnancy has been debated. Although correlating with IVF success, the relationship between morphology and pregnancy success, either naturally or with IUI are, at best, controversial associations.…”

Section: Reactive Oxygen Speciesmentioning

confidence: 99%

An Assessment of New Sperm Tests for Male Infertility

Natali

Turek

2011

Urology

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The routine semen analysis, although used for more than 50 years, fails to accurately distinguish between fertile and infertile men. As a consequence, many tests of sperm function (TSF) have been developed. This review discusses both older and newer diagnostic TSF. It outlines the principles underlying each assay and reviews aggregate clinical data to determine its current relevance and utility. It concludes that the relevance of many older TSF is questionable, with the wide acceptance of intracytoplasmic sperm injection (ICSI). Newer TSF have the potential to deliver more clinically relevant information but require more extensive study to better understand their predictive role in the ICSI era. UROLOGY 77: 1027-1034, 2011. © 2011 Elsevier Inc. All rights reserved.I n addition to the medical history and physical examination, the conventional semen analysis has been an essential laboratory test for the evaluation of male fertility for at least 50 years. However, the idea that fertility can be defined by threshold values of semen parameters is a concept that is fundamentally flawed. 1 Although not a true measure of fertility, the semen analysis, if abnormal, suggests that the probability of achieving fertility is lower than normal. 2 Because of biological variability, two semen analyses are generally needed, performed with two to three days of sexual abstinence and evaluated in a standardized fashion. 2 Recognized normal values for semen parameters are given in Table 1 in agreement with the latest recommendations by the World Health Organization (WHO). 2 Traditionally, (except for the latest WHO recommendations), these references are derived by expert consensus and not by prospective clinical trials and thus their true relationship to male fertility is unclear. In addition, the definition of what constitutes "normal" semen parameters is constantly challenged. A meta-analysis of 29 US studies of semen quality from 9612 fertile, or presumably fertile, men suggested that a sperm concentration of 98 million/mL is normal. 3 Although sperm motility is considered the "best" predictor of fertility, normal sperm motility ranges from 53% to 62%. 4 Thus, simply deriving "normal" semen parameters has been a prohibitively lengthy and inconclusive process to date.Finally, other biological variables affect the clinical utility of the semen analysis. In addition to wide intraindividual variation, seasonal 5 and geographic variation 4 further complicate the performance of the semen analysis as a fertility measure. As examples, within-subject, interejaculate coefficients of variation for sperm concentration and motility are estimated at 44.7% and 15% in one study. 1 Thus, even with excellent quality control, wide biological variation in semen quality profoundly challenges the notion that the conventional semen analysis can accurately assess male fertility. OLDER ADJUNCTIVE SPERM TESTSBecause of the need to more precisely characterize normal fertile semen, adjunctive semen testing has become popular (Figure 1). The concept behind de...

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