Improved pregnancy rates in male factor by hyaluronic acid binding sperm selection and msome in ART

Abstract

OBJECTIVE: Implantation and Pregnancy rates after ICSI is positive correlated with morphological nuclear normality of spermatozoa. Sperm with a morphologically abnormal nucleus usually have low fertility potential. The MSOME (Motile sperm organelle morphology examination) method let to show the morphological normality of sperm cell organelles observed at high magnification. Spermatozoa have a specific affinity to bind HA (hyaluronic acid) a natural protein found in the cumulus complex surrounding the oocyte. The aim of this study was to compare the pregnancy, implantation and miscarriages rates when we combined two sperm selection techniques: HA binding test and MSOME before ICSI versus conventional ICSI.DESIGN: Retrospective and Descriptive study.MATERIALS AND METHODS: Study from august 2009 to January 2010 of 40 patients with female ages between 30 and 38 years old, with severe male factor who underwent to ICSI. We divided the patients in two groups: 20 patients for Group I (HA plus MSOME prior ICSI) and 20 patients for Group II (Conventional ICSI). Mann–Whitney U-tests were carried out. Significance was defined as p < 0.05.RESULTS: A total of 82 embryos were transferred. The media of embryos transferred were 2.05 per patient. Pregnancy, implantation and miscarriage rates were: 65.00 %, 26.82% and 18.18% in Group I versus 47.00%, 15.78 % and 33.33% in group II respectively. This preliminary results shows statistical differences between both groups in favor of group I.CONCLUSION: The combination of HA binding test plus MSOME seems to improve success rates for Reproductive Assisted Techniques in male factor. These results suggest that morphologically normal sperm have higher chance to bind HA and therefore MSOME selection of spermatozoa is probably more easy and faster. These two tests for normal morphologically sperm selection will be incorporated in our daily routine before the ICSI procedure. To confirm the effect of HA sperm selection and MSOME on the ICSI outcome further studies are required. OBJECTIVE: Implantation and Pregnancy rates after ICSI is positive correlated with morphological nuclear normality of spermatozoa. Sperm with a morphologically abnormal nucleus usually have low fertility potential. The MSOME (Motile sperm organelle morphology examination) method let to show the morphological normality of sperm cell organelles observed at high magnification. Spermatozoa have a specific affinity to bind HA (hyaluronic acid) a natural protein found in the cumulus complex surrounding the oocyte. The aim of this study was to compare the pregnancy, implantation and miscarriages rates when we combined two sperm selection techniques: HA binding test and MSOME before ICSI versus conventional ICSI. DESIGN: Retrospective and Descriptive study. MATERIALS AND METHODS: Study from august 2009 to January 2010 of 40 patients with female ages between 30 and 38 years old, with severe male factor who underwent to ICSI. We divided the patients in two groups: 20 patients for Group I (HA plus MSOME prior ICSI) and 20 patients for Group II (Conventional ICSI). Mann–Whitney U-tests were carried out. Significance was defined as p < 0.05. RESULTS: A total of 82 embryos were transferred. The media of embryos transferred were 2.05 per patient. Pregnancy, implantation and miscarriage rates were: 65.00 %, 26.82% and 18.18% in Group I versus 47.00%, 15.78 % and 33.33% in group II respectively. This preliminary results shows statistical differences between both groups in favor of group I. CONCLUSION: The combination of HA binding test plus MSOME seems to improve success rates for Reproductive Assisted Techniques in male factor. These results suggest that morphologically normal sperm have higher chance to bind HA and therefore MSOME selection of spermatozoa is probably more easy and faster. These two tests for normal morphologically sperm selection will be incorporated in our daily routine before the ICSI procedure. To confirm the effect of HA sperm selection and MSOME on the ICSI outcome further studies are required.