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Mizuno K, Okitsu O, Goto M, Kusuhara A, Kusuhara K. Polyvinylpyrrolidone can prevent oolemma lysis caused by abnormal rupture of the plasma membrane in Piezo-ICSI. Hum Cell 2024; 37:951-958. [PMID: 38615310 DOI: 10.1007/s13577-024-01061-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Accepted: 03/24/2024] [Indexed: 04/15/2024]
Abstract
The aim of this study was to investigate whether it is possible to prevent oolemma lysis after Piezo-assisted intracytoplasmic sperm injection (Piezo-ICSI) caused by abnormal membrane rupture. A total of 489 mature oocytes were obtained from 85 patients who underwent Piezo-ICSI in an infertility clinic. Inseminated oocytes were classified into the following two groups: normal rupture and abnormal rupture, and a portion of abnormally ruptured oocytes was randomly exposed to 7% PVP solution. Normal fertilization rate, degeneration rate, proportion of high-quality embryos on day 3, blastocyst formation, and morphologically high-quality blastocysts were compared. Abnormal rupture was defined as cytoplasmic membrane rupture before piezo pulse driving. Among the abnormal rupture groups, the normal fertilization and degeneration rates were compared between the high-stretched (ruptured at ≥ 50% during oocyte membrane stretching) and low-stretched (< 50% position) oocytes.The degeneration rate was significantly higher in abnormally ruptured oocytes than in normally ruptures oocytes (14.3% vs 1.3%, p < 0.001), and there was no significant difference in embryonic development after fertilization. PVP treatment immediately after oolemma rupture significantly decreased the degeneration rate (6.0% vs 19.7%, p = 0.031) and increased the normal fertilization rate. Similarly, there were no significant differences in the developmental potential. Furthermore, pregnancy outcome data showed no significant differences in pregnancy and live birth rates. The degeneration rate was reduced by treating low-stretched oocytes with PVP.Exposure to polyvinylpyrrolidone (PVP) immediately after abnormal membrane rupture represents an effective strategy to prevent oocyte degeneration. This is the first study to propose a strategy for the prevention of oocyte degeneration in Piezo-ICSI. These findings are expected to reduce the oocyte degeneration rate and increase normal fertilization rate as well as assist patients who can only acquire oocytes with weak plasma membranes.
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Affiliation(s)
| | | | - Mako Goto
- Kusuhara Women's Clinic, Chuo-Ku, Tokyo, Japan
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Thompson JG, McLennan HJ, Heinrich SL, Inge MP, Gardner DK, Harvey AJ. A brief history of technical developments in intracytoplasmic sperm injection (ICSI). Dedicated to the memory of J.M. Cummins. Reprod Fertil Dev 2024; 36:RD24047. [PMID: 38902908 DOI: 10.1071/rd24047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2024] [Accepted: 05/29/2024] [Indexed: 06/22/2024] Open
Abstract
Intracytoplasmic sperm injection (ICSI) is an assisted reproductive technology for treatment of severe male infertility introduced into clinical practice in 1992. This review provides a brief history of the development of ICSI by acknowledging major developments in the field. The review addresses key developments in pre-clinical and early studies, how ICSI compares with in vitro fertilisation, long-term consequences, how the mechanistic approach to ICSI has changed in both manual and semi-automated approaches, and how sperm selection procedures are integrated into ICSI. From the beginnings using animal models in the 1960-1970s, the development of ICSI is a remarkable and transformative success story. Indeed, its broad use (70% of cycles globally) exceeds the need required for treating infertile males, and this remains a controversial issue. There remain questions around the long-term health impacts of ICSI. Furthermore, advances in automation of the ICSI procedure are occurring. An estimated 6million children have been born from the ICSI procedure. With further automation of sperm selection technologies, coupled with automation of the injection procedure, it is likely that the proportion of children born from ICSI will further increase.
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Affiliation(s)
- J G Thompson
- Fertilis Pty Ltd, Frome Road, Helen Mayo South, The University of Adelaide, Adelaide, SA 5005, Australia; and Robinson Research Institute, Adelaide Medical School, The University of Adelaide, Adelaide, SA 5005, Australia; and ART Lab Solutions Pty Ltd, 10 Pulteney Street, Adelaide, SA 5005, Australia
| | - H J McLennan
- Fertilis Pty Ltd, Frome Road, Helen Mayo South, The University of Adelaide, Adelaide, SA 5005, Australia
| | - S L Heinrich
- Fertilis Pty Ltd, Frome Road, Helen Mayo South, The University of Adelaide, Adelaide, SA 5005, Australia
| | - M P Inge
- Fertilis Pty Ltd, Frome Road, Helen Mayo South, The University of Adelaide, Adelaide, SA 5005, Australia
| | - D K Gardner
- Melbourne IVF, East Melbourne, Vic 3002, Australia; and School of BioSciences, University of Melbourne, Parkville, Vic 3010, Australia
| | - A J Harvey
- Melbourne IVF, East Melbourne, Vic 3002, Australia; and School of BioSciences, University of Melbourne, Parkville, Vic 3010, Australia
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Zander-Fox D, Green M, Watson K, Turner R, Bakos HW, Foo J, Pacella-Ince L, Caddy M, McPherson NO, Rombauts L. Improved fertilization, degeneration, and embryo quality rates with PIEZO-intracytoplasmic sperm injection compared with conventional intracytoplasmic sperm injection: a sibling oocyte split multicenter trial. Fertil Steril 2024; 121:971-981. [PMID: 38272382 DOI: 10.1016/j.fertnstert.2024.01.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Revised: 12/20/2023] [Accepted: 01/17/2024] [Indexed: 01/27/2024]
Abstract
OBJECTIVE To investigate whether PIEZO-intracytoplasmic sperm injection (PIEZO-ICSI) increases the fertilization rate, decreases the degeneration rate, and increases the utilization rate per oocyte injected compared with conventional intracytoplasmic sperm injection (ICSI). DESIGN Sibling oocyte split multicenter trial. SETTING Fertility clinics. PATIENTS Women with a diagnosis of infertility who used ICSI as their method of insemination and had ≥6 mature oocytes for injection. INTERVENTIONS Participants had their mature oocyte cohort divided, where half were injected using conventional ICSI and the other half were injected using PIEZO-ICSI. For patients with an uneven oocyte number, the extra oocyte was injected using conventional ICSI. The injection technique used first was also randomized to ensure that there was no bias due to order of injection. MAIN OUTCOME MEASURE The primary outcome measure was the fertilization rate after injection. RESULTS A total of 108 patients underwent a sibling split use of conventional ICSI and PIEZO-ICSI. The fertilization rate was 71.6% in PIEZO-ICSI, which significantly increased compared with that in conventional ICSI 65.6%. In addition, the oocyte degeneration rate decreased in PIEZO-ICSI compared with that in conventional ICSI (6.3% vs. 12.1% respectively), and the blastocyst quality increased, as measured by the number of grade A and B quality blastocysts present on day 5 of development (33.3% vs. 27.5%). No significant differences in the aneuploidy or utilization rate, clinical pregnancy, or live birth outcome after single embryo transfer were noted between the two injection techniques. CONCLUSIONS This trial supports the possibility that PIEZO-ICSI increases the fertilization rates, decreases the oocyte degeneration rates, and increases the blastocyst quality compared with conventional ICSI; however, it does not appear to influence the clinical pregnancy or live birth rate per transfer. CLINICIAN TRIAL REGISTRATION NUMBER Australian and New Zealand Clinical Trial Registry ACTRN12620000407998.
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Affiliation(s)
- Deirdre Zander-Fox
- Monash IVF Group, Melbourne, Victoria, Australia; School of Biomedicine, University of Adelaide, Adelaide, South Australia, Australia; Biomedicine Discovery Institute, Monash University, Melbourne, Victoria, Australia.
| | - Mark Green
- Monash IVF Group, Melbourne, Victoria, Australia; School of BioSciences, University of Melbourne, Melbourne, Victoria, Australia
| | - Kate Watson
- Monash IVF Group, Melbourne, Victoria, Australia
| | - Ross Turner
- Monash IVF Group, Melbourne, Victoria, Australia
| | - Hassan W Bakos
- Monash IVF Group, Melbourne, Victoria, Australia; School of Environmental and Life Sciences, College of Engineering, Science and Environment, University of Newcastle, Newcastle, New South Wales
| | - Jinny Foo
- Monash IVF Group, Melbourne, Victoria, Australia
| | - Leanne Pacella-Ince
- Monash IVF Group, Melbourne, Victoria, Australia; School of Biomedicine, University of Adelaide, Adelaide, South Australia, Australia
| | | | - Nicole O McPherson
- Monash IVF Group, Melbourne, Victoria, Australia; School of Biomedicine, University of Adelaide, Adelaide, South Australia, Australia; Freemasons Centre for Male Health and Wellbeing, University of Adelaide, Adelaide, South Australia, Australia
| | - Luk Rombauts
- Monash IVF Group, Melbourne, Victoria, Australia; Biomedicine Discovery Institute, Monash University, Melbourne, Victoria, Australia
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Shioya M, Okabe-Kinoshita M, Kobayashi T, Fujita M, Takahashi K. Human metaphase II oocytes with narrow perivitelline space have poor fertilization, developmental, and pregnancy potentials. J Assist Reprod Genet 2024; 41:1449-1458. [PMID: 38499932 PMCID: PMC11143139 DOI: 10.1007/s10815-024-03084-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Accepted: 03/04/2024] [Indexed: 03/20/2024] Open
Abstract
PURPOSE To analyze the fertilization, developmental, and pregnancy potentials in oocytes with narrow perivitelline space. METHODS Perivitelline space (PVS) of oocytes was evaluated at the time of ICSI, and those without sufficient PVS were judged as oocytes with narrow PVS (NPVS oocytes), and those with sufficient PVS formation were judged as oocytes with non-narrow PVS (non-NPVS oocytes). The analysis included 634 NPVS oocytes from 278 cycles and 12,121 non-NPVS oocytes from 1698 cycles. The fertilization and developmental potentials of NPVS and non-NPVS oocytes were compared by calculating odds ratios using a mixed-effects logistic regression model. We also compared the embryo transfer outcomes of those used for single vitrified-warmed blastocyst transfer after developing into the blastocyst stage. RESULTS NPVS oocytes had higher odds ratios for degeneration (adjusted odds ratio [aOR], 1.555; 95% confidence interval [CI], 1.096-2.206; p = 0.0133) and 0PN (aOR, 1.387; 95% CI, 1.083-1.775; p = 0.0095), resulting in a lower 2PN rate (aOR, 0.761; 95% CI, 0.623-0.929; p = 0.0072). Even embryos with confirmed 2PN had lower odds ratios for cleavage (aOR, 0.501; 95% CI, 0.294-0.853; p = 0.0109) and blastocyst development (Gardner criteria; CC-AA) rates (aOR, 0.612; 95% CI, 0.476-0.788; p = 0.0001). Blastocysts developed from NPVS oocytes had significantly lower odds ratios for clinical pregnancy (aOR, 0.435; 95% CI, 0.222-0.854; p = 0.0156) than those developed from non-NPVS oocytes. CONCLUSIONS Oocytes with NPVS have low fertilization and developmental potential, as well as low likelihood of pregnancy.
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Affiliation(s)
- Masashi Shioya
- Takahashi Women's Clinic, 18-14-6F Shinmachi, Chuo-ku, Chiba, 260-0028, Japan.
- Department of Reproductive Medicine, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, 260-8670, Japan.
| | | | - Tatsuya Kobayashi
- Department of Reproductive Medicine, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, 260-8670, Japan
- Department of Regulatory Science, Fujita Health University, Haneda Innovation City Zone A, 1-1-4 Haneda Airport, Ota-ku, Tokyo, 144-0041, Japan
| | - Maki Fujita
- Takahashi Women's Clinic, 18-14-6F Shinmachi, Chuo-ku, Chiba, 260-0028, Japan
| | - Keiichi Takahashi
- Takahashi Women's Clinic, 18-14-6F Shinmachi, Chuo-ku, Chiba, 260-0028, Japan
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Morimoto T, Maekawa T, Mizuta S, Matsubayashi H, Takeuchi T, Hata Y, Ishikawa T. Identifying optimal puncture position by a real-time image analysis for Piezo-ICSI: a prospective randomized sibling oocyte study. Reprod Biomed Online 2024; 48:103735. [PMID: 38402676 DOI: 10.1016/j.rbmo.2023.103735] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2023] [Revised: 11/13/2023] [Accepted: 11/17/2023] [Indexed: 02/27/2024]
Abstract
RESEARCH QUESTION Would the use of the intracytoplasmic sperm injection (ICSI) position detector (IPD) make it possible to identify the optimal puncture position on oolemma during Piezo-ICSI and reduce oocyte degeneration and unintentional membrane rupture (UMR)? DESIGN This sibling oocyte study included 917 inseminated oocytes from 113 infertile patients undergoing Piezo-ICSI. Oocytes were randomly divided into two groups: with or without IPD. The rates of UMR, degeneration, fertilization and embryonic development were compared between the two groups. As a secondary analysis, non-IPD oocytes were retrospectively assessed as appropriate or non-appropriate injection sites and analysed alongside prospective 'appropriate' injections. RESULTS The rates of UMR (7.0% versus 12.9%, P = 0.004) and degeneration (2.4% versus 6.1%, P < 0.01 = 0.008) were significantly lower in the IPD group than in the non-IPD group. No significant differences, however, were observed in the rates of fertilization (two pronuclei, 83.8% versus 78.9%), blastocyst formation (48.5% versus 48.8%) or good-quality blastocysts (22.5% versus 20.5%). Additionally, no significant differences were observed in the rates of pregnancy (29.4% versus 35.1%) or live births (26.5% versus 29.7%) in a single embryo transfer setting with or without IPD. Comparing all 'appropriate' injections with 'non-appropriate' injections also showed a significantly decreased rate of UMR and degeneration (both P ≤ 0.001). CONCLUSIONS The present study demonstrated that a real-time image analysis during Piezo-ICSI markedly reduced oocyte degeneration by avoiding areas associated with a high risk of UMR. Therefore, IPD may increase the number of embryos available for treatment.
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Affiliation(s)
- Takashi Morimoto
- Department of Reproductive Medicine, Reproduction Clinic Tokyo: Shiodome City Center 3F, 1-5-2 Higashi-shimbashi, Minato-ku, Tokyo, 105-7103 Japan..
| | - Tomohiro Maekawa
- Department of Reproductive Medicine, Reproduction Clinic Tokyo: Shiodome City Center 3F, 1-5-2 Higashi-shimbashi, Minato-ku, Tokyo, 105-7103 Japan
| | - Shimpei Mizuta
- Department of Reproductive Medicine, Reproduction Clinic Tokyo: Shiodome City Center 3F, 1-5-2 Higashi-shimbashi, Minato-ku, Tokyo, 105-7103 Japan
| | - Hidehiko Matsubayashi
- Department of Reproductive Medicine, Reproduction Clinic Tokyo: Shiodome City Center 3F, 1-5-2 Higashi-shimbashi, Minato-ku, Tokyo, 105-7103 Japan
| | - Takumi Takeuchi
- Department of Reproductive Medicine, Reproduction Clinic Tokyo: Shiodome City Center 3F, 1-5-2 Higashi-shimbashi, Minato-ku, Tokyo, 105-7103 Japan
| | - Yutaka Hata
- Graduate School of Information Science, University of Hyogo, 7-1-28, Minatojimaminami-cho, Chuo-ku, Kobe, 650-0047 Japan
| | - Tomomoto Ishikawa
- Department of Reproductive Medicine, Reproduction Clinic Tokyo: Shiodome City Center 3F, 1-5-2 Higashi-shimbashi, Minato-ku, Tokyo, 105-7103 Japan
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Vergara F, Fernández J, Pedrosa C, Muñoz M, Jerez E, Varón M, Moyano C, Yoldi A, Ponce J. Comparative study of intracytoplasmic sperm injection using the traditional holding and the oocyte-holding pipette without aspiration. ZYGOTE 2024; 32:96-101. [PMID: 38173402 DOI: 10.1017/s0967199423000618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2024]
Abstract
Despite the high level of standardization of the intracytoplasmic sperm injection (ICSI) technique, there are some aspects that deserve special attention and should still be improved. The major drawback of the technique is its invasiveness, as during cytoplasmic aspiration different structures of the oocyte may be lost or damaged. This is partly because the microtools used in ICSI were not specially designed for assisted reproduction but for other medical-biological disciplines. In view of the above caveats, the aim of the study was to compare the results of ICSI with the traditional oocyte-holding pipette and the oocyte-holding pipette without aspiration (PiWA). In total, 155 patients and 1037 oocytes were included in the study. In each ICSI cycle, half of the oocytes were microinjected using a traditional holding pipette and the other half using a PiWA. In result, the PiWA technique produced a significant increase in the fertilization rate: 88.12% (95%CI: 84.62-90.92%); holding pipette: 73.33% (95%CI: 68.72-77.49%). Also, it produced a significant decrease in the embryo degeneration rate compared with the traditional holding pipette [PiWA: 2.07% (95%CI: 1.11-3.8%); holding pipette: 4.51% (95%CI: 3.06-6.59%)]. Pregnancy rate depended on the holding technique used, both in single embryo transfers (n = 59; χ2 = 4.608; P-value = 0.032) and double embryo transfers (n = 156; χ2 = 4.344; P-value = 0.037); with PiWA presenting a significantly higher pregnancy rate than the traditional holding technique. Based on current evidence and the present results, improvements should focus on decreasing the invasiveness of the microinjection itself by minimizing or avoiding aspiration and cytoplasmic disorganization, as is successfully achieved with PiWA.
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McLennan HJ, Heinrich SL, Inge MP, Wallace SJ, Blanch AJ, Hails L, O'Connor JP, Waite MB, McIlfatrick S, Nottle MB, Dunning KR, Gardner DK, Thompson JG, Love AK. A micro-fabricated device (microICSI) improves porcine blastocyst development and procedural efficiency for both porcine intracytoplasmic sperm injection and human microinjection. J Assist Reprod Genet 2024; 41:297-309. [PMID: 38236552 PMCID: PMC10894805 DOI: 10.1007/s10815-023-03018-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Accepted: 12/21/2023] [Indexed: 01/19/2024] Open
Abstract
PURPOSE Intracytoplasmic sperm injection (ICSI) imparts physical stress on the oolemma of the oocyte and remains among the most technically demanding skills to master, with success rates related to experience and expertise. ICSI is also time-consuming and requires workflow management in the laboratory. This study presents a device designed to reduce the pressure on the oocyte during injection and investigates if this improves embryo development in a porcine model. The impact of this device on laboratory workflow was also assessed. METHODS Porcine oocytes were matured in vitro and injected with porcine sperm by conventional ICSI (C-ICSI) or with microICSI, an ICSI dish that supports up to 20 oocytes housed individually in microwells created through microfabrication. Data collected included set-up time, time to align the polar body, time to perform the injection, the number of hand adjustments between controllers, and degree of invagination at injection. Developmental parameters measured included cleavage and day 6 blastocyst rates. Blastocysts were differentially stained to assess cell numbers of the inner cell mass and trophectoderm. A pilot study with human donated MII oocytes injected with beads was also performed. RESULTS A significant increase in porcine blastocyst rate for microICSI compared to C-ICSI was observed, while cleavage rates and blastocyst cell numbers were comparable between treatments. Procedural efficiency of microinjection was significantly improved with microICSI compared to C-ICSI in both species. CONCLUSION The microICSI device demonstrated significant developmental and procedural benefits for porcine ICSI. A pilot study suggests human ICSI should benefit equally.
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Affiliation(s)
- Hanna J McLennan
- Fertilis Pty Ltd, Frome Road, Helen Mayo South, The University of Adelaide, Adelaide, SA, 5005, Australia.
| | - Shauna L Heinrich
- Fertilis Pty Ltd, Frome Road, Helen Mayo South, The University of Adelaide, Adelaide, SA, 5005, Australia
| | - Megan P Inge
- Fertilis Pty Ltd, Frome Road, Helen Mayo South, The University of Adelaide, Adelaide, SA, 5005, Australia
| | - Samuel J Wallace
- Virtual Ark Pty Ltd, 73 Woolnough Road, Semaphore, SA, 5019, Australia
| | - Adam J Blanch
- Fertilis Pty Ltd, Frome Road, Helen Mayo South, The University of Adelaide, Adelaide, SA, 5005, Australia
| | - Llewelyn Hails
- Fertilis Pty Ltd, Frome Road, Helen Mayo South, The University of Adelaide, Adelaide, SA, 5005, Australia
| | - John P O'Connor
- Fertilis Pty Ltd, Frome Road, Helen Mayo South, The University of Adelaide, Adelaide, SA, 5005, Australia
| | - Michael B Waite
- Fertilis Pty Ltd, Frome Road, Helen Mayo South, The University of Adelaide, Adelaide, SA, 5005, Australia
| | - Stephen McIlfatrick
- School of Biomedicine, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, SA, 5005, Australia
- Robinson Research Institute, Adelaide Medical School, The University of Adelaide, Adelaide, SA, 5005, Australia
| | - Mark B Nottle
- School of Biomedicine, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, SA, 5005, Australia
- Robinson Research Institute, Adelaide Medical School, The University of Adelaide, Adelaide, SA, 5005, Australia
| | - Kylie R Dunning
- School of Biomedicine, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, SA, 5005, Australia
- Robinson Research Institute, Adelaide Medical School, The University of Adelaide, Adelaide, SA, 5005, Australia
- Australian Research Council Centre of Excellence for Nanoscale BioPhotonics, The University of Adelaide, Adelaide, SA, 5005, Australia
- Institute for Photonics and Advanced Sensing, The University of Adelaide, Adelaide, SA, 5005, Australia
| | - David K Gardner
- Fertilis Pty Ltd, Frome Road, Helen Mayo South, The University of Adelaide, Adelaide, SA, 5005, Australia
- Melbourne IVF, East Melbourne, VIC, 3002, Australia
- School of BioSciences, University of Melbourne, Parkville, VIC, 3010, Australia
| | - Jeremy G Thompson
- Fertilis Pty Ltd, Frome Road, Helen Mayo South, The University of Adelaide, Adelaide, SA, 5005, Australia.
- Robinson Research Institute, Adelaide Medical School, The University of Adelaide, Adelaide, SA, 5005, Australia.
- ART Lab Solutions Pty Ltd, 10 Pulteney Street, Adelaide, SA, 5005, Australia.
| | - Allison K Love
- Fertilis Pty Ltd, Frome Road, Helen Mayo South, The University of Adelaide, Adelaide, SA, 5005, Australia
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Asada Y. Evolution of intracytoplasmic sperm injection: From initial challenges to wider applications. Reprod Med Biol 2024; 23:e12582. [PMID: 38803410 PMCID: PMC11129627 DOI: 10.1002/rmb2.12582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Revised: 03/18/2024] [Accepted: 04/29/2024] [Indexed: 05/29/2024] Open
Abstract
Background In vitro fertilization (IVF) has revolutionized infertility treatment. Nevertheless, male infertility requires more effective solutions. In 1992, the first-ever case of human birth via intracytoplasmic sperm injection (ICSI) was reported. ICSI involves microscopically injecting a sperm into an ovum. Successful ICSI has become a reliable therapy for couples facing infertility, a significant milestone. However, it has also introduced various challenges. This study also delves into ethical dilemmas arising from widespread ICSI use. Methods This review traces the history of ICSI, presenting pioneering attempts, first successful attempts, and critical reports on account of the initial skepticism toward the technology. The review also focuses on chronological progress until ICSI was recognized as effective and became widely applied. Main findings The review reveals that ICSI, although transformative, presents challenges. Successes include addressing male infertility and aiding fertilization. However, concerns arise regarding optimal sperm and embryo selection, genetic mutations, and long-term health implications. Ethical considerations surrounding ICSI's broad applications also surface. Conclusions Despite its success and effectiveness, ICSI is still evolving as a therapeutic method. By comprehensively evaluating the historical progress and the current status of ICSI and exploring its future prospects, this study highlights the importance of ICSI in infertility treatment.
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Costa-Borges N, Munné S, Albó E, Mas S, Castelló C, Giralt G, Lu Z, Chau C, Acacio M, Mestres E, Matia Q, Marquès L, Rius M, Márquez C, Vanrell I, Pujol A, Mataró D, Seth-Smith M, Mollinedo L, Calderón G, Zhang J. First babies conceived with Automated Intracytoplasmic Sperm Injection. Reprod Biomed Online 2023; 47:103237. [PMID: 37400320 DOI: 10.1016/j.rbmo.2023.05.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Revised: 05/14/2023] [Accepted: 05/17/2023] [Indexed: 07/05/2023]
Abstract
RESEARCH QUESTION Can an automated sperm injection robot perform Automated Intracytoplasmic Sperm Injection (ICSIA) for use in human IVF? DESIGN The ICSIA robot automated the sperm injection procedure, including injection pipette advancement, zona pellucida and oolemma penetration with piezo pulses, and pipette removal after sperm release. The robot was first tested in mouse, hamster and rabbit oocytes, and subsequently using discarded human oocytes injected with microbeads. A small clinical pilot trial was conducted with donor oocytes to study the feasibility of the robot in a clinical setting. The ICSIA robot was controlled by engineers with no micromanipulation experience. Results were compared with those obtained with manual ICSI conducted by experienced embryologists. RESULTS The ICSIA robot demonstrated similar results to the manual procedure in the different animal models tested as well as in the pre-clinical validations conducted in discarded human oocytes. In the clinical validation, 13 out of 14 oocytes injected with ICSIA fertilized correctly versus 16 out of 18 in the manual control; eight developed into good-quality blastocysts versus 12 in the manual control; and four were diagnosed as chromosomally normal versus 10 euploid in the manual control. Three euploid blastocysts from the ICSIA robot group have been transferred into two recipients, which resulted in two singleton pregnancies and two babies born. CONCLUSIONS The ICSIA robot showed high proficiency in injecting animal and human oocytes when operated by inexperienced personnel. The preliminary results obtained in this first clinical pilot trial are within key performance indicators.
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Affiliation(s)
| | | | | | | | | | | | - Zhuo Lu
- New Hope Fertility Center, NY, USA
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Alikani M. The success of ICSIA and the tough road to automation. Reprod Biomed Online 2023; 47:103244. [PMID: 37419763 DOI: 10.1016/j.rbmo.2023.06.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/09/2023]
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Caddy M, Popkiss S, Weston G, Vollenhoven B, Rombauts L, Green M, Zander-Fox D. PIEZO-ICSI increases fertilization rates compared with conventional ICSI in patients with poor prognosis. J Assist Reprod Genet 2023; 40:389-398. [PMID: 36586007 PMCID: PMC9935778 DOI: 10.1007/s10815-022-02701-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Accepted: 12/17/2022] [Indexed: 01/01/2023] Open
Abstract
PURPOSE Limited research has been published comparing PIEZO-ICSI with conventional ICSI. While positive effects have been documented in improving fertilization and degeneration, the outcomes in patients with previous poor results from conventional ICSI remain unclear. It is hypothesized that these patients may benefit the most from this form of insemination. METHODS This retrospective paired within-patient cohort study investigated patients (n=72) undertaking PIEZO-ICSI after a previous conventional ICSI cycle resulted in poor outcomes (including low fertilization (<50%), high degeneration (>15%), and/or poor embryo development and utilization). Patients required at least five oocytes collected in both cycles and a period of less than 2 years between the cycles. The outcomes of both cycles were compared in respect to fertilization, degeneration, embryo utilization, and pregnancy rates. Further analyses were applied to patients <38 and ≥38 years of age, with <50% or ≥50% fertilization with conventional ICSI and with <20% or ≥20% utilization with conventional ICSI. RESULTS PIEZO-ICSI resulted in significantly higher fertilization (61.9% vs 45.3%, P<0.0001) and lower degeneration (7.7% vs 18.2%, P=0.0001) when compared to the conventional ICSI cycles. The greatest benefit was seen in patients who had less than 50% fertilization or <20% utilization in their conventional ICSI cycle, with improvements in fertilization and degeneration rates resulting in a significantly higher number of embryos utilized (frozen or transferred) per cycle. CONCLUSIONS PIEZO-ICSI improved fertilization, degeneration, and utilization rates in patients with previous poor outcomes from conventional ICSI. The number of embryos available for use per cycle was also increased. Further significant improvements were achieved in patients who exhibited poor fertilization (<50%) or low utilization (<20%) from conventional ICSI.
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Affiliation(s)
- Melissa Caddy
- Monash IVF, Melbourne, Australia.
- Monash IVF Group, 252-256 Clayton Rd, Clayton, Victoria, 3168, Australia.
| | | | - Gareth Weston
- Monash IVF, Melbourne, Australia
- Monash Health, Melbourne, Australia
| | - Beverley Vollenhoven
- Monash IVF, Melbourne, Australia
- Monash Health, Melbourne, Australia
- Department of Obstetrics and Gynaecology, School of Clinical Science, Monash University, Melbourne, Australia
| | - Luk Rombauts
- Monash IVF, Melbourne, Australia
- Monash Health, Melbourne, Australia
- Department of Obstetrics and Gynaecology, School of Clinical Science, Monash University, Melbourne, Australia
| | - Mark Green
- Monash IVF, Melbourne, Australia
- School of BioSciences, University of Melbourne, Melbourne, Australia
| | - Deirdre Zander-Fox
- Monash IVF, Melbourne, Australia
- Department of Obstetrics and Gynaecology, School of Clinical Science, Monash University, Melbourne, Australia
- University of Adelaide, Adelaide, Australia
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What Does Intracytoplasmic Sperm Injection Change in Embryonic Development? The Spermatozoon Contribution. J Clin Med 2023; 12:jcm12020671. [PMID: 36675600 PMCID: PMC9867417 DOI: 10.3390/jcm12020671] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Revised: 12/30/2022] [Accepted: 01/11/2023] [Indexed: 01/19/2023] Open
Abstract
The intracytoplasmic sperm injection (ICSI) technique was invented to solve severe male infertility due to altered sperm parameters. Nowadays, it is applied worldwide for the treatment of couple infertility. ICSI is performed with any available spermatozoon from surgery or ejaculated samples, whatever are the sperm motility, morphology or quantity. The aim of the present review was to study if embryo development and kinetics would be modified by (1) ICSI under the technical aspects, (2) the micro-injected spermatozoa in connection with male infertility. From published data, it can be seen that ICSI anticipates the zygote kinetics Furthermore, because fertilization rate is higher in ICSI compared to conventional in vitro fertilization (IVF), more blastocysts are obtained for clinical use in ICSI. Sperm and spermatozoa characteristics, such as sperm parameters, morphology and vitality, DNA content (levels of sperm DNA fragmentation, microdeletions, and chromosomal abnormalities), RNA content, epigenetics, and sperm recovery site (testicular, epididymis, and ejaculated), have an impact on fertilization and blastocyst rates and embryo kinetics in different ways. Even though ICSI is the most common solution to solve couples' infertility, the causes of male infertility are crucial in building a competent spermatozoa that will contribute to normal embryonic development and healthy offspring.
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13
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Bovine ICSI: limiting factors, strategies to improve its efficiency and alternative approaches. ZYGOTE 2022; 30:749-767. [PMID: 36082429 DOI: 10.1017/s0967199422000296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Intracytoplasmic sperm injection (ICSI) is an assisted reproductive technique mainly used to overcome severe infertility problems associated with the male factor, but in cattle its efficiency is far from optimal. Artificial activation treatments combining ionomycin (Io) with 6-dimethylaminopurine after piezo-ICSI or anisomycin after conventional ICSI have recently increased the blastocyst rate obtained. Compounds to capacitate bovine spermatozoa, such as heparin and methyl-β-cyclodextrin and compounds to destabilize sperm membranes such as NaOH, lysolecithin and Triton X-100, have been assessed, although they have failed to substantially improve post-ICSI embryonic development. Disulfide bond reducing agents, such as dithiothreitol (DTT), dithiobutylamine and reduced glutathione, have been assessed to decondense the hypercondensed head of bovine spermatozoa, the two latter being more efficient than DTT and less harmful. Although piezo-directed ICSI without external activation has generated high fertilization rates and modest rates of early embryo development, other studies have required exogenous activation to improve the results. This manuscript thoroughly reviews the different strategies used in bovine ICSI to improve its efficiency and proposes some alternative approaches, such as the use of extracellular vesicles (EVs) as 'biological methods of oocyte activation' or the incorporation of EVs in the in vitro maturation and/or culture medium as antioxidant defence agents to improve the competence of the ooplasm, as well as a preincubation of the spermatozoa in estrous oviductal fluid to induce physiological capacitation and acrosome reaction before ICSI, and the use of hyaluronate in the sperm immobilization medium.
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14
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Calcium chloride dihydrate supplementation at ICSI improves fertilization and pregnancy rates in patients with previous low fertilization: a retrospective paired treatment cycle study. J Assist Reprod Genet 2022; 39:1055-1064. [PMID: 35262809 PMCID: PMC9107552 DOI: 10.1007/s10815-022-02407-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Accepted: 01/18/2022] [Indexed: 10/18/2022] Open
Abstract
PURPOSE To determine if 5mM calcium chloride dihydrate supplementation of the Polyvinylpyrrolidone (PVP) media at the time of ICSI (ICSI-Ca) improves fertilization, utilization, and clinical pregnancy rates compared to ICSI alone, particularly in patients with a history of low fertilization (< 50%). METHODS Retrospective study between 2016 and 2021 at Monash IVF Victoria on a paired cohort of patients (n = 178 patients) where an ICSI cycle was analyzed coupled with the subsequent ICSI-Ca cycle. The paired cohort was further subdivided into a low-fertilization cohort (< 50% fertilization on previous cycles: n = 66 patients) compared to the remaining patients with fertilization ≥ 50% (n = 122). Exclusion criteria included donor cycles, PGT patients, surgical sperm retrieval, women ≥ 45 years old, patients with > 6 cycles, and patients with ≤ 5 inseminated oocytes. RESULTS Calcium supplementation significantly increased both fertilization (28.8% ICSI vs 49.7% ICSI-Ca, P < 0.0001) and clinical pregnancy rate (4.9% ICSI vs 25.0% ICSI-Ca: P < 0.05) in the low-fertilization cohort but not in the normal-fertilization cohort. Interestingly, utilization rate significantly increased in the normal-fertilization cohort (32.6% ICSI vs ICSI-Ca: 44.9%, P < 0.01) but not in the low-fertilization cohort, although the number of embryos utilized per patient after ICSI-Ca increased in both groups. CONCLUSION Calcium supplementation does not appear to be a detrimental addition to ICSI and may improve IVF outcomes, particularly for patients with a history of low fertilization. Further investigations including prospective case-matched studies or a RCT are required to confirm these findings.
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15
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Hiraoka K, Uchida N, Ishikawa T, Kawai K. Value of Meiotic Spindle Imaging on Fertilization and Embryo Development Following Human Oocyte Piezo-ICSI. FERTILITY & REPRODUCTION 2022. [DOI: 10.1142/s2661318222500049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Background: The objective of this study was to investigate accurately the effect of the meiotic spindle imaging of human oocytes on their fertilization and embryo development by using the Piezo-ICSI. Methods: We retrospectively assessed 529 oocytes with the first polar body retrieved from 124 infertile couples (147 cycles) who attended our clinic between May 2016 and December 2018. Of these, 489 oocytes (92.4%) with visible meiotic spindle comprised the Spindle (+) group and 40 oocytes (7.6%) not observed meiotic spindle comprised the Spindle (−) group. The meiotic spindle was imaged using polarized light microscopy. The rates of fertilization, high-quality day-3 embryo, day-5 blastocyst, and high-quality day-5 blastocyst were evaluated in both groups. Results: The fertilization rates of Spindle (+) and Spindle (−) were 92.0% (450/489) and 70.0% (28/40), respectively; high-quality day-3 embryo rates were 62.9% (283/450) and 35.7% (10/28); day-5 blastocyst rates were 53.7% (205/382) and 32.1% (9/28); high-quality day-5 blastocyst rates were 29.8% (114/382) and 3.6% (1/28). Fertilization, high-quality day-3 embryo, day-5 blastocyst, and high-quality day-5 blastocyst rates were significantly higher in the Spindle (+) group than in the Spindle (−) group. Conclusion: Spindle imaging (i.e., oocytes with a visible meiotic spindle or with not observed meiotic spindle) influences the outcome of Piezo-ICSI in human oocytes, including fertilization and embryo development. To our knowledge, this study is the first to evaluate the effect of meiotic spindle imaging on fertilization or embryo development among oocytes after Piezo-ICSI. The meiotic spindle imaging could be the indicator for the quality management of medical doctors and embryologists.
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Affiliation(s)
- Kenichiro Hiraoka
- Kameda IVF Clinic Makuhari, Makuhari Techno Garden D3F, 1-3 Nakase Mihama-ku, Chiba 261-8501, Japan
- Kameda Medical Center, 929 Higashi-cho, Kamogawa-shi, Chiba 296-8602, Japan
- Tokyo Medical and Dental University, 1-5-45, Yushima, Bunkyo-ku, Tokyo 113-8519, Japan
| | - Nozomi Uchida
- Kameda IVF Clinic Makuhari, Makuhari Techno Garden D3F, 1-3 Nakase Mihama-ku, Chiba 261-8501, Japan
| | - Tomonori Ishikawa
- Tokyo Medical and Dental University, 1-5-45, Yushima, Bunkyo-ku, Tokyo 113-8519, Japan
| | - Kiyotaka Kawai
- Kameda IVF Clinic Makuhari, Makuhari Techno Garden D3F, 1-3 Nakase Mihama-ku, Chiba 261-8501, Japan
- Kameda Medical Center, 929 Higashi-cho, Kamogawa-shi, Chiba 296-8602, Japan
- Tokyo Medical and Dental University, 1-5-45, Yushima, Bunkyo-ku, Tokyo 113-8519, Japan
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