#269 : Replacing Crude ICSI: Improving Poor Egg Reserve and Poor Responder Patient Outcomes by Replacing Conventional ICSI with Positive Rheotaxis Extended Drop (PRED-ICSI) Technique

Abstract

Background and Aims: Positive rheotaxis extended drop (PRED) has been described by Martin et al, 2017 showing sperm with <1% DFI index. Our results on 25 embryonic failure patients presented in WebRepro 2021 PRED showed improved outcomes. (18% vs 45% Utilized blastocyst rate) vs Conventional-ICSI (C-ICSI) To evaluate effects in poor egg reserve we designed a prospective comparative pilot study of patients with low AMH or poor responder status evaluating PRED-ICSI vs C-ICSI Method: PRED-ICSI vs C-ICSI alternated every cycle of poor responder or poor egg quality for a period of 3 months from Jan 23[Formula: see text], 2023, to March 23[Formula: see text], 2023. Results: Age of male partner and female partner were higher in PRED-ICSI. The egg reserve and attempt number were similar. Semen parameters trended higher in conventional ICSI vs PRED ICSI group. PRED-ICSI had higher fertilization than C-ICSI (74% C-ICSI vs 80% PRED ICSI). Results trend higher in utilized blastocyst rate (47% C-ICSI vs 64% PRED ICSI). In the C-ICSI group 4 patients who had D3 frozen or with Embryo transfer had only grade b or lower embryos available vs No patients with grade b or lower embryos in the PRED-ICSI group. 3 patients had cycle cancellation due to no embryos in C-ICSI group vs 1 patients in PRED-ICSI group. Patients with grade AA/AB blastocysts were 7 out of 12 in Conventional ICSI group (50%) vs 8 out of 12 in PRED-ICSI (66.67%). Conclusion: This data furthers proof that PRED-ICSI can replace C-ICSI in patients with poor egg reserve or poor responder status. PRED-ICSI can effectively replace C-ICSI as a superior zero additional cost technique for selection of spermatozoa with an improved sperm chromatin pool vs Conventional ICSI which is a crude method of sperm selection.