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Chua SC, Yovich SJ, Hinchliffe PM, Yovich JL. The Sperm DNA Fragmentation Assay with SDF Level Less Than 15% Provides a Useful Prediction for Clinical Pregnancy and Live Birth for Women Aged under 40 Years. J Pers Med 2023; 13:1079. [PMID: 37511693 PMCID: PMC10381567 DOI: 10.3390/jpm13071079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Revised: 06/23/2023] [Accepted: 06/25/2023] [Indexed: 07/30/2023] Open
Abstract
This retrospective cohort study was conducted on 1148 males who presented along with their partners for infertility management at the PIVET Medical Centre between 2013 and 2022 and had a sperm DNA fragmentation (SDF) assay performed by Halosperm, thereafter participating in 1600 assisted reproductive technology (ART) cycles utilising one of three modalities, namely, IVF-Only, ICSI-Only or IVF-ICSI Split cycles. The outcomes from the ART cycles were then analysed as two groups based on SDF levels <15% and ≥15%. The study showed the unadjusted fertilization rates were not different between the groups, neither across the four female age ranges. However, when the fertilization rates were adjusted for the mature oocytes (metaphase-II oocytes), there was a highly significant difference in fertilization rates in favour of the group with SDF levels < 15% where the women were in the younger age grouping of <35 years (78.4% vs. 73.0%; p < 0.0001). Overall, there was no difference in the rates of blastocyst development nor clinical pregnancy rates between the two SDF groups, but there was a significantly higher pregnancy rate for the younger women (<35 years) with the group of SDF level < 15% (44.1% vs. 37.4%; p = 0.04). Similarly, there was no difference in the miscarriage rates overall with respect to SDF groups, and no clear picture could be deciphered among the women's age groups. With respect to cumulative live births, this reflected the pregnancy rates with no overall difference between the two SDF groups, but there was a significantly higher cumulative live birth rate for women <35 years where the SDF level was <15% (38.6% vs. 28.6%; p < 0.01). Among the three modalities, the highest cumulative live birth rate occurred within the group with SDF level < 15%, being highest with the IVF mode, particularly for women aged <40 years (43.0% vs. 37.7% for IVF-ICSI Split and 27.9% for ICSI; p = 0.0002), noting that the IVF case numbers were disproportionately low.
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Affiliation(s)
- Shiao Chuan Chua
- PIVET Medical Centre, Perth, WA 6007, Australia
- Hospital Shah Alam, Shah Alam 40000, Malaysia
| | | | | | - John Lui Yovich
- PIVET Medical Centre, Perth, WA 6007, Australia
- Curtin Medical School, Curtin University, Perth, WA 6102, Australia
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Emirdar V, Karatasli V, Tamer B, Pala I, Gunturkun F, Ozbaykus C, Işık AZ, Gode F. Influence of a hyaluronan-binding system for sperm selection in intracytoplasmic sperm injection cycles on embryo morphokinetic parameters and in vitro fertilization cycle outcomes. Arch Gynecol Obstet 2023; 307:1633-1639. [PMID: 36892604 DOI: 10.1007/s00404-023-06992-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Accepted: 02/15/2023] [Indexed: 03/10/2023]
Abstract
PURPOSE Although the impact of the paternal contribution to embryo quality and blastocyst formation is a well-known phenomenon, the current literature provides insufficient evidence that hyaluronan-binding sperm selection methods improve assisted reproductive treatment outcomes. Thus, we compared the cycle outcomes of morphologically selected intracytoplasmic sperm injection (ICSI) with hyaluronan binding physiological intracytoplasmic sperm injection (PICSI) cycles. METHODS A total of 2415 ICSI and 400 PICSI procedures of 1630 patients who underwent in vitro fertilization cycles using a time-lapse monitoring system between 2014 and 2018 were analyzed retrospectively. Fertilization rate, embryo quality, clinical pregnancy rate, biochemical pregnancy rate and miscarriage rate were evaluated, differences in morphokinetic parameters and cycle outcomes were compared. RESULTS In total, 85.8 and 14.2% of the whole cohort were fertilized with standard ICSI and PICSI, respectively. The proportion of fertilized oocytes did not significantly differ between groups (74.53 ± 1.33 vs. 72.92 ± 2.64, p > 0.05). Similarly, the proportion of good-quality embryos according to the time-lapse parameters and the clinical pregnancy rate did not significantly differ between groups (71.93 ± 4.21 vs. 71.33 ± 2.64, p > 0.05 and 45.55 ± 2.91 vs. 44.96 ± 1.25, p > 0.05). No statistically significant differences were found between groups in clinical pregnancy rates (45.55 ± 2.91 vs. 44.96 ± 1.25, p > 0.05). Biochemical pregnancy rates (11.24 ± 2.12 vs. 10.85 ± 1.83, p > 0.05) and miscarriage rates (24.89 ± 3.74 vs. 27.91 ± 4.91, p > 0.05) were not significantly different between groups. CONCLUSION The effects of the PICSI procedure on fertilization rate, biochemical pregnancy rate, miscarriage rate, embryo quality, and clinical pregnancy outcomes were not superior. The effect of the PICSI procedure on embryo morphokinetics was not apparent when all parameters were considered.
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Affiliation(s)
- Volkan Emirdar
- Department of Obstetrics and Gynecology, Izmir Economy University School of Medicine, Medical Park Hospital, Yeni Girne Blv. 1825 Street No: 12 Karşıyaka, Izmir, Turkey. .,Izmir Economy University Medical Park Hospital In Vitro Fertilization Unit, Yeni Girne Blv. 1825 Street No: 12 Karşıyaka, Izmir, Turkey.
| | - Volkan Karatasli
- Department of Obstetrics and Gynecology, SBU. University of Health Science Tepecik Education and Research Hospital, Yenisehir, Gaziler St. No:468, Konak, 35020, Izmir, Turkey
| | - Burcu Tamer
- Izmir Economy University Medical Park Hospital In Vitro Fertilization Unit, Yeni Girne Blv. 1825 Street No: 12 Karşıyaka, Izmir, Turkey
| | - Ibrahim Pala
- Izmir Economy University Medical Park Hospital In Vitro Fertilization Unit, Yeni Girne Blv. 1825 Street No: 12 Karşıyaka, Izmir, Turkey
| | - Fatma Gunturkun
- Center for Biomedical Informatics, The University of Tennessee Health Science Center, 875 Monroe Avenue, Memphis, TN, USA
| | - Canberk Ozbaykus
- Intensive Care Unit, Taksim Education and Research Hospital, Katip Mustafa Celebi, Sıraselviler Street No:48, Beyoglu, 34433, Istanbul, Turkey
| | - Ahmet Zeki Işık
- Department of Obstetrics and Gynecology, Izmir Economy University School of Medicine, Medical Park Hospital, Yeni Girne Blv. 1825 Street No: 12 Karşıyaka, Izmir, Turkey.,Izmir Economy University Medical Park Hospital In Vitro Fertilization Unit, Yeni Girne Blv. 1825 Street No: 12 Karşıyaka, Izmir, Turkey
| | - Funda Gode
- Department of Obstetrics and Gynecology, Izmir Economy University School of Medicine, Medical Park Hospital, Yeni Girne Blv. 1825 Street No: 12 Karşıyaka, Izmir, Turkey.,Izmir Economy University Medical Park Hospital In Vitro Fertilization Unit, Yeni Girne Blv. 1825 Street No: 12 Karşıyaka, Izmir, Turkey
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Sachs MK, Makieva S, Dedes I, Kalaitzopoulos DR, El-Hadad S, Xie M, Velasco A, Stiller R, Leeners B. Higher miscarriage rate in subfertile women with endometriosis receiving unbiopsied frozen-warmed single blastocyst transfers. Front Cell Dev Biol 2023; 11:1092994. [PMID: 37123402 PMCID: PMC10140404 DOI: 10.3389/fcell.2023.1092994] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Accepted: 04/07/2023] [Indexed: 05/02/2023] Open
Abstract
Background: Assisted reproductive technology treatment is recommended to overcome endometriosis-associated infertility but current evidence is controversial. Endometriosis is associated with lower antral follicle count (AFC) and oocyte yield but similar clinical outcomes compared to controls. Unaffected ovarian stimulation response and embryological outcomes but lower clinical pregnancy and live birth rates and higher miscarriage rates have been reported, implying direct impact on endometrial receptivity. With evidence emerging on the benefit of frozen-warmed and blastocyst stage transfer, we investigated ART outcomes in endometriosis using homogeneous case-control groups. Methods: This is a retrospective observational case-control study including n = 66 frozen-warmed unbiopsied single blastocyst transfers of patients with endometriosis and n = 96 of women exhibiting idiopathic sterility. All frozen-warmed transfers followed artificial endometrial preparation. Results: In control women, the mean number of oocytes recovered at oocyte pick up was higher compared to women with endometriosis (15.3 ± 7.1 vs. 12.7 ± 5.2, p = 0.025) but oocyte maturation index (mature oocytes/total oocytes at oocyte pick up) was significantly higher for endometriosis (48.2% vs. 34.0%, p = 0.005). The same was shown for the subgroup of 44 endometriosis patients after endometrioma surgery when compared with controls (49.1% vs. 34.0%, p = 0.014). Clinical pregnancy rate was not higher in endometriosis but was close to significance (47.0% vs. 32.3%, p = 0.059) while live birth rate was comparable (27.3% vs. 32.3%, p = 0.746). Miscarriage rate was higher in the endometriosis group (19.7% vs. 7.3%, p = 0.018). A significantly higher AFC was observed in the control group in comparison with the endometriosis group (16.3 ± 7.6 vs. 13.4 ± 7.0, p = 0.014). Live birth rate did not differ when comparing all endometriosis cases (p = 0.746), ASRM Stage I/II and Stage III/IV (p = 0.348 and p = 0.888) with the control group but the overall pregnancy rate was higher in ASRM Stage I/II (p = 0.034) and miscarriage rate was higher in ASRM Stage III/IV (p = 0.030) versus control. Conclusion: Blastocyst transfers in women with endometriosis originate from cycles with lower AFC but higher share of mature oocytes than in control women, suggesting that endometriosis might impair ovarian reserve but not stimulation response. A higher miscarriage rate, independent of blastocyst quality may be attributed to an impact of endometriosis on the endometrium beyond the timing of implantation.
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Affiliation(s)
- M. K. Sachs
- Department of Reproductive Endocrinology, University Hospital Zurich, Zurich, Switzerland
- *Correspondence: M. K. Sachs,
| | - S. Makieva
- Department of Reproductive Endocrinology, University Hospital Zurich, Zurich, Switzerland
| | - I. Dedes
- Department of Gynaecology, University Hospital Zurich, Zurich, Switzerland
| | - D. R. Kalaitzopoulos
- Department of Reproductive Endocrinology, University Hospital Zurich, Zurich, Switzerland
- Department of Gynaecology, University Hospital Zurich, Zurich, Switzerland
| | - S. El-Hadad
- Department of Reproductive Endocrinology, University Hospital Zurich, Zurich, Switzerland
| | - M. Xie
- Department of Reproductive Endocrinology, University Hospital Zurich, Zurich, Switzerland
| | - A. Velasco
- Department of Reproductive Endocrinology, University Hospital Zurich, Zurich, Switzerland
| | - R. Stiller
- Department of Reproductive Endocrinology, University Hospital Zurich, Zurich, Switzerland
| | - B. Leeners
- Department of Reproductive Endocrinology, University Hospital Zurich, Zurich, Switzerland
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Franasiak JM, Polyzos NP, Neves AR, Yovich JL, Ho TM, Vuong LN, Norman RJ. Intracytoplasmic sperm injection for all or for a few? Fertil Steril 2022; 117:270-284. [DOI: 10.1016/j.fertnstert.2021.12.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Accepted: 12/02/2021] [Indexed: 11/04/2022]
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