Abstract
PurposeThe aim of our study was to evaluate the impact of severe male infertility (SMF) on the chromosomal status of embryos and any possible correlation between chromosomal status and embryo morphokinetics in younger women using data obtained from comprehensive preimplantation genetic tests.MethodsThe trial was conducted in an ART and Reproductive Genetics Centre between 2011 and 2018. A total of 326 cycles in cases with SMF where the female partner’s age was ≤ 35 years were evaluated. SMF is defined as sperm concentration below 5 mil/ml (million per milliliter) and divided into three subgroups according to sperm concentrations: 1–5 mil/ml, < 1mil/ml and testicular sperm. The control group of 190 cycles had normal sperm parameters.ResultsSignificantly lower chromosomal euploidy rates were found in the testicular sperm group compared with the normal sperm controls when the female age was ≤ 35 years. In SMF, statistically significantly affected chromosomes were 2, 10, 11, 17, 21 and sex chromosomes. The mosaicism and abnormal morphokinetic development rates were higher in the SMF group than in control group, and this difference was significant when testicular sperm was used.ConclusionLower euploidy rates, higher mosaicism rates and a higher incidence of abnormal morphokinetic development were observed in cases with testicular sperm with female partners ≤ 35 years compared with normal sperm controls. These findings suggest that PGT-A may be advisable in severe male infertility cases. Furthermore, the correlation between morphokinetics and chromosomal status was greatly reduced or absent in these most severe forms of male infertility, thus the need for new morphokinetic models.
Highlights
Male infertility is a factor in approximately 50% of ART cases
Mazzili et al (2017), reporting on the effect of the male factor on the clinical outcome of intracytoplasmic sperm injection combined with preimplantation aneuploidy testing, concluded that the euploidy rate and implantation potential of the obtained blastocysts are independent from sperm quality but that severe male infertility (SMF) impairs early embryonic competence
The aim of our study was to evaluate the impact of severe male infertility on the chromosomal status of embryos and any possible correlation between chromosomal status and embryo morphokinetics in younger women using data obtained from comprehensive preimplantation genetic tests
Summary
Male infertility is a factor in approximately 50% of ART cases. Just over 20% are diagnosed with severe male factor infertility, which is defined as sperm concentration below 5 million per ml [1]. Mazzili et al (2017), reporting on the effect of the male factor on the clinical outcome of intracytoplasmic sperm injection combined with preimplantation aneuploidy testing, concluded that the euploidy rate and implantation potential of the obtained blastocysts are independent from sperm quality but that SMF impairs early embryonic competence. The poor pattern of aster formation from the testicular centrosome was associated with delayed first cleavage, slower developmental rate and reduced formation of morulae and blastocyst. Improvement was reported when testicular sperm centrosome was replaced by a centrosome from an ejaculated spermatozoon, which resulted in higher rates of embryo development comparable with data from ejaculated spermatozoa
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