V7-02 ROBOTIC LEVEL 3 CAVA THROMBECTOMY

Abstract

increased DNA fragmentation and clinical outcome from IMSI, although results are conflicting. The aim of this study was to compare pregnancy rate (PR) from standard intra-cytoplasmic sperm injection (ICSI) and IMSI, in couples who had failed previous ART attempts in whom the male partner had been demonstrated to have a raised DFI. METHODS: Data was collected prospectively between July 2011 and October 2012 at a fertility clinic. Couples who had undergone at least one previous failed attempt of ART at the clinic were advised DNA fragmentation testing using the TUNEL technique. DNA fragmentation was considered raised if the index (DFI) was above 30%. Couples were offered either standard ICSI or IMSI and PR, live birth rates (LBR) and miscarriage rates were compared. Sperm for injection with the IMSI technique were selected under 6600 x magnification based on the motile sperm organelle morphology examination (MSOME) as previously described by Bartoov et. al. RESULTS: 54 couples were included in the study analysis (ICSI, n1⁄420; IMSI n1⁄434). Mean age in women (ICSI, 38; IMSI, 37) (p1⁄40.14) and menwere similar in both groups (ICSI, 40; IMSI, 42) (p1⁄40.31). There was no statistical difference in themeanDFI in both coupleswho had ICSI and IMSI (ICSI, 44.3%; IMSI, 48.3%) (p1⁄40.34). Therewas no difference in the number of oocytes collected (ICSI, 9.0; IMSI, 12.5) (p1⁄40.06) or in the number of oocytes fertilized (ICSI, 5.1; IMSI 6.7) (p1⁄40.17). Two women who had ICSI had no fertilization of their oocytes on the day following egg collection and were excluded in the final analysis. Of women who had embryo transfer (n1⁄452), there was no difference in PR (ICSI, 55.6%; IMSI, 52.9%) (p1⁄40.56) or LBR (0.61)(ICSI, 50.0%; IMSI, 50.0%) between groups. Miscarriage rate was 5.6% in the ICSI group and 8.8% in the IMSI group. CONCLUSIONS: This study would suggest that IMSI may not improve the pregnancy outcome from ART in couples where men are found to have high DNA fragmentation.