Comparison of Intracytoplasmic Sperm Injection Outcome with Sperm Selection Techniques in Oligoasthenozoospermic Males: A Randomized Controlled Trial

Abstract

Background: Male infertility rate has increased over the recent years across the globe. Intracytoplasmic sperm injection (ICSI) is mainly used to treat male infertility; however, in this method, sperm selection plays a critical role in improving ICSI outcome. Objectives: The aim of this study was to evaluate the efficiency of three sperm selection techniques on ICSI outcomes in oligoasthenozoospermic men. Methods: This randomized clinical trial study was performed on 80 oligoasthenozoospermic (OAS) couples receiving ICSI in Milad Infertility Center, Mashhad, Iran from October 2016 to June 2017. The couples were randomly assigned to the three groups of control, hypo-osmotic swelling test (HOST) and hyaluronic acid (HA) according to the sperm selection technique for ICSI. Fertilization rate, embryo development (ED), embryo quality (EQ) and implantation rate (IR) were evaluated and compared among the groups. Results: Our results showed that there was no significant difference in fertilization rate between the studied groups. ED rate was increased in the HOST and HA groups compared to the control group, but this difference was not significant. EQ was increased in the HOST (P = 0.001) and HA groups (P = 0.001) compared to the control group. IR was enhanced in the HA group in comparison with the control group (P = 0.021), but there was no significant difference between the HOST and HA groups. Conclusions: The results of this study showed that for achieving successful clinical outcomes and improved embryo quality and implantation rate in oligoasthenozoospermic males undergoing Intracytoplasmic sperm injection, effective sperm selection through either the HOST or HA technique is necessary.