Intracytoplasmic Sperm Injection Outcomes Research Articles

Association of Methylenetetrahydrofolate Reductase Gene Polymorphism C677T with Oocyte Number and Embryo Quality in Iraqi Infertile Women Undergoing Intracytoplasmic Sperm Injection

Background: Methylenetetrahydrofolate reductase (MTHFR) C677T is a single nucleotide polymorphism (SNP) that affects the production of 5-methyltetrahydrofolate (5-MTHF), the active folate that enables the recycling of homocysteine (Hcy) to methionine. Objective: to investigate the association between the MTHFR (C677T) polymorphism and the outcomes of intracytoplasmic sperm injection (ICSI). Methods: A prospective cohort study included 85 infertile women undergoing ICSI treatment at the High Institute of Infertility Diagnosis and Assisted Reproductive Technologies in Baghdad, Iraq. The study period extended from January 2022 to September 2023. The MTHFR C677T polymorphism genotyping was evaluated in these patients, and they were classified into three groups according to genotyping results: normal (CC), heterozygote mutated (CT), and mutated homozygote (TT). In addition, we conducted a comparative analysis of oocyte, embryo and pregnancy rates among these three groups. Results: In comparison to the CT and TT genotypes, the total number of oocytes, total embryos, mature oocytes, good-quality embryos, and pregnancy rate were all found to be significantly higher (p<0.05) in the CC genotype. Compared to the CC group, the proportion of immature oocytes and poor-quality embryos was significantly higher in the TT and CT groups (p<0.05). The rate of fertilization was comparable among the study groups. Conclusions: The maternal MTHFR C677T polymorphism is linked to oocyte number, maturity, total embryo, embryo quality, and pregnancy in ICSI. In light of this, MTHFR polymorphism in our community offers useful data regarding the success of ICSI.

Comparison of Embryological Results of Microinjection in Two Groups of Men with and without Requesting Sperm DNA Fragmentation Index Measurement.

The sperm DNA fragmentation index (DFI) is considered a valuable measure to assess male fertility, but the predictive value of DFI for the outcomes in assisted reproductive technology (ART) is still controversial. Therefore, this study is aimed at investigating the effect of requesting a DFI test or performing ART without DFI on the results observed in the embryology laboratory (number of embryos, fertilization rate, and embryo quality) after intracytoplasmic sperm injection (ICSI). This retrospective study was conducted on infertile men who underwent ICSI and were referred to the Avicenna Infertility and Recurrent Abortion Treatment Center in Tehran from 2019 to 2022. The samples were categorized into two groups: a case group with DFI measurement and a control group without DFI measurement. We conducted a comparative analysis of the embryology results between the two groups, focusing on parameters such as fertilization rate, number of embryos, and embryo quality. t-tests and Mann-Whitney U tests were used to conduct single variable analysis. Potential confounding effects were adjusted to use the multivariate linear and logistic regression. Data analysis showed no significant statistical difference between the case group and the control group in terms of the number of embryos (95% confidence interval for the regression coefficient (β) = -0.257-0.123), and embryo quality (95% confidence interval for β = -0.199-0.114). There was no significant statistical difference between the two groups due to the fertilization rate (95% confidence interval for β = -3.42-3.42), except for the variables of woman's age and sperm count after ICSI, as determined by adjusted linear regression. Although DFI measurement is used to assess male infertility, its importance as a predictor for the embryology outcomes after ICSI requires further evaluation and the determination of a cut-off point for predicting results. This study was based on retrospectively collected DFI data, and prospective studies confirming the superiority of ICSI outcomes are necessary.

The Role of Vitamin D in Determining Intra-Cytoplasmic Sperm Injection Outcome: A Prospective Cohort Study

The Role of Vitamin D in Determining Intra-Cytoplasmic Sperm Injection Outcome: A Prospective Cohort Study

Very severe oligozoospermia with AZFc microdeletion patients may affect intracytoplasmic sperm injection clinical outcomes: A propensity score matching analysis.

To explore whether spermatozoa from AZFc microdeletion patients affect their outcomes of intracytoplasmic sperm injection (ICSI). Eighty-five patients with AZFc microdeletion were recruited. A control group of one hundred and forty patients with severe oligozoospermia but without AZF microdeletion was selected using propensity score matching analysis with a 1:2 nearest neighbor algorithm ratio. The ICSI outcomes of the two groups were compared. AZFc microdeletion had lower rates of normal fertilization (73% vs. 80%, p = 0.17) and high-quality embryos (44% vs. 58%, p = 0.07) than the control group. There was no significant difference in the clinical pregnancy rate, miscarriage rate, and live birth rate between the two groups. When the sperm concentration was <1 million/mL, the AZFc microdeletion group exhibited lower rates of fertilization (71% vs. 80%, p = 0.03), high-quality embryo (44% vs. 58%, p = 0.02), clinical pregnancy (57% vs. 76%, p = 0.02), and live birth (49% vs. 72%, p = 0.01) than the control group. However, if sperm concentration was ≥1 million/mL, no significant differences were found. If the sperm concentration is <1 million/mL, AZFc microdeletion do have a detrimental effect on most outcomes of ICSI.

Sperm Selection Using Zona Pellucida-Binding Enhanced Embryo Morphokinetic and Clinical Outcomes in ICSI: A Sibling Oocytes Study.

The objective was to investigate the embryo morphokinitics using a time-lapse monitoring (TLM) system and assessment of clinical outcomes following intracytoplasmic sperm injection (ICSI) with zona pellucida (ZP)-bound sperm selection and conventional methods. A total of 371 metaphase II (MII) oocytes from 50 ICSI cycles were studied. Sibling oocytes were randomly divided into control (n = 199) and ZP-bound group (n = 172). All resulting zygotes were cultured and monitored in the TLM system up to Day 3 after ICSI. Fertilization rate, early embryo development, and clinical outcomes were evaluated. No significant differences were found in fertilization rate, time-lapse qualitative and quantitative measures, pronuclear fading time (PNF) t2, t3, t4, t5, t6, and t7 (times of cleavage to 2, 3, 4, 5, 6, and 7 cells), respectively. However, the t8 (time of cleavage to eight cells) and cc3 (duration of third cell cycle) revealed a significant difference between control and ZP-bound groups (p < .05). A significant difference between the two groups (p < .05) in the rates of Grade A embryos (according to Basile algorithm), chemical pregnancy, clinical pregnancy, and implantation was observed. Sperm selection using biological materials, such as ZP, improved both embryo quality and pregnancy outcomes, despite not affecting the early embryo development and morphokinetic parameters up to t8. This prospective randomized sibling oocyte trial was registered in October 2020 to January 2022 (IRCT20200705048021N1).

Differences in clinical outcomes between men with mosaic Klinefelter syndrome and those with non-mosaic Klinefelter syndrome.

This study compared the clinical outcomes of men with Klinfelter syndrome based on karyotype. The authors analyzed the outcomes of microdissection testicular sperm extraction (micro-TESE) performed on 57 patients with Klinfelter syndrome (KS) at our clinic. The average ages of the non-mosaic and mosaic KS groups were 32.2 ± 4.8 and 45.9 ± 13.1 years, respectively. The sperm retrieval rates of the non-mosaic and mosaic KS groups were 46.5% (20/43) and 50.0% (7/14), respectively. The fertilization rates after intracytoplasmic sperm injection did not significantly differ between the non-mosaic and mosaic KS groups. The mosaic KS group had higher cleavage and blastocyst development rates than the non-mosaic KS group (72.2% vs. 96.2% and 30.5% vs. 44.7%, respectively). The group using motile sperm had better outcomes than the group using immotile sperm. The embryo transfer outcomes of the non-mosaic and mosaic KS groups did not significantly differ (clinical pregnancy rate: 28.0% vs. 20.7%, miscarriage rate: 14.3% vs. 33.3%, production rate per transfer: 22.0% vs. 13.8%, and production rate per case: 58.8% vs. 57.1%). Compared with the non-mosaic KS group, the mosaic KS group had significantly better intracytoplasmic sperm injection outcomes because of the higher utilization rate of motile sperm.

Does Intramuscular Injection of Human Chorionic Gonadotropin before Frozen Embryo Transfer Improve Intracytoplasmic Sperm Injection Outcomes?

Does Intramuscular Injection of Human Chorionic Gonadotropin before Frozen Embryo Transfer Improve Intracytoplasmic Sperm Injection Outcomes?

Evaluation of medical equipment of the infertility treatment centers in North western of Libya

Background Cell culture, particularly in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI) are both of which assisted reproductive technology (ART) approaches that are most frequently utilized to treat infertility around the world. Objective Highlight the differences and similarities in instruments and equipment in ART laboratories that govern their success, limitations, and potential differences between laboratories by identifying the facilities of laboratories to improve outcomes of ICSI and IVF techniques in clinical centers on the western coast of Libya. Method: descriptive study, comparison of five (5) assisted reproduction laboratories instrument and equipment parameters using the same quality-control application in clinical centers on the western coast of Libya.Result: Among the seven clinical centers specializing in the diagnosis and treatment of infertility that were contacted, four infertility treatment centers and the Medical Research Center (MRC) provided a response. The MRC and four clinical centres had good laboratory facilities for ICSI and IVF techniques compared to Jordan ART laboratory facilities.Conclusion: This study highlights the imperative of enhancing laboratory infrastructure to support optimal implementation of ICSI and IVF procedures.

Reliability of hypo-osmotic swelling test on fresh and frozen-thawed ejaculated or testicular immotile sperm: A sibling oocyte study

The viability of sperm is a crucial factor for achieving a successful pregnancy in intracytoplasmic sperm injection (ICSI) cycles. The aim of this study was to evaluate the accuracy of the hypo-osmotic swelling test (HOST) in fresh and frozen-thawed sperm samples of different origins (ejaculated/testicular). A retrospective analysis was conducted on the outcomes of 2167 oocytes subjected to ICSI using motile and immotile-HOST-positive sperm from 2011 to 2023. We evaluated embryonic development, as well as clinical, obstetric, and neonatal outcomes in four groups based on different sperm origins (ejaculated/testicular) and processing (fresh/frozen). When comparing the results of ICSI between motile and immotile-HOST-positive sperm within each group, it was observed that there were no significant differences in the outcomes for fresh samples. However, for frozen-thawed samples, fertilization rates and blastocyst development rates were significantly lower when ICSI was performed with immotile-HOST-positive sperm compared to motile sperm. Of note, clinical, obstetric, and neonatal outcomes were statistically similar across all groups. Our findings indicate that HOST is more reliable in fresh samples than in those subjected to the freeze–thaw process. Nonetheless, HOST is considered a safe method for selecting viable sperm in all subgroups.

A Comparison of ICSI Outcomes and Reactive Oxygen Species Levels in Seminal Plasma between Normozoospermia and Sperm Abnormalities Groups for Infertile Men

Background: Social life and the healthcare systems are affected by infertility. Infertility could be primary or secondary; secondary infertility is the inability to conceive after one successful pregnancy while primary infertility is the inability to conceive at all. As sperm abnormalities cause male infertility, Intracytoplasmic Sperm Injection (ICSI) is a particular type of in vitro fertilization (IVF) used to treat severe male-factor infertility. Free radical oxygen derivatives are reactive oxygen species (ROS). Reactive oxygen species may cause 30% to 80% of male infertility. Aims of the study: the present study aims to determine the reactive oxygen species level in seminal plasma and to study the Intracytoplasmic Sperm Injection outcomes for Normospermia group and compare it with Oligozoospermia, Asthenozoospermia and the Teratozoospermia Groups. Material, and Methods: a cross-sectional study was conducted between January 2023 to June 2023 in Najaf, on a non-random sampling including 50 couples who suffered from a minimum of 12 months of primary fertility with regular unprotected sexual intercourse and who had attended the fertility center in Najaf requesting fertility treatment. A gynecological examination and assessment were done for the female participants while the urologists examined and assessed the male subjects; then, a semen analysis was carried out followed by macroscopic and microscopic examinations. After the preparation of the sample for ICSI and performing ICSI, pregnancy was assessed and the outcomes of the different groups were compared. At the same time, reactive oxygen species levels were assessed by using the Human Reactive Oxygen Species ELISA kit. Then, the SPSS version 26 was used to perform the statistical analysis. Results: Among the twenty-one patients with Normozoospermia, seven with Asthenospermic, seven with Oligozoospermia and fifteen with Teratozoospermia, there was a significant difference among the four groups regarding sperm concentration, progressive motility, and sperm normal morphology. There was no significant difference among the type of sperm, Normo, Astheno, Tearato, and Oligozoospermia, regarding birth rate and ICSI outcomes. Males with higher progressive motility showed a higher pregnancy rate. In conclusion, despite the presence of reactive oxygen species, Intracytoplasmic Sperm Injection was advantageous and effective for all four groups. reactive oxygen species had no significant effect on Intracytoplasmic Sperm Injection outcomes, however Normozoospermia was associated with greater pregnancy rates. Despite the presence of reactive oxygen species, Intracytoplasmic Sperm Injection was advantageous and effective for all four groups. ROS had no significant effect on Intracytoplasmic Sperm Injection outcomes, however Normozoospermia was associated with greater pregnancy rates.

Y chromosome microdeletions in Chinese men with infertility: prevalence, phenotypes, and intracytoplasmic sperm injection outcomes

BackgroundThe incidence of Y chromosome microdeletions varies among men with infertility across regions and ethnicities worldwide. However, comprehensive epidemiological studies on Y chromosome microdeletions in Chinese men with infertility are lacking. We aimed to investigate Y chromosome microdeletions prevalence among Chinese men with infertility and its correlation with intracytoplasmic sperm injection (ICSI) outcomes.MethodsThis single-center retrospective study included 4,714 men with infertility who were evaluated at the Reproductive Center of the First Affiliated Hospital of Sun Yat-sen University between May 2017 and January 2021. Semen analysis and Y-chromosome microdeletion via multiplex polymerase chain reaction were conducted on the men. The study compared outcomes of 36 ICSI cycles from couples with male azoospermia factor (AZF)cd deletions with those of a control group, which included 72 ICSI cycles from couples without male Y chromosome microdeletions, during the same period. Both groups underwent ICSI treatment using ejaculated sperm.ResultsAmong 4,714 Chinese men with infertility, 3.31% had Y chromosome microdeletions. The combined deletion of sY254 and sY255 in the AZFc region and sY152 in the AZFd region was the prevalent pattern of Y chromosome microdeletion, with 3.05% detection rate. The detection rates of AZF deletions in patients with normal total sperm count, mild oligozoospermia, severe oligozoospermia, cryptozoospermia, and azoospermia were 0.17%, 1.13%, 5.53%, 71.43%, and 7.54%, respectively. Compared with the control group, the AZFcd deletion group exhibited no significant difference in the laboratory results or pregnancy outcomes of ICSI cycles using ejaculated sperm.ConclusionsThis is the largest epidemiological study on Y chromosome microdeletions in Chinese men with infertility. The study results underline the necessity for detecting Y chromosome microdeletion in men with infertility and severe sperm count abnormalities, especially those with cryptozoospermia. The combined deletion of sY254 and sY255 in the AZFc region and sY152 in the AZFd region was the most prevalent Y chromosome microdeletion pattern. Among patients with AZFcd deletion and ejaculated sperm, ICSI treatment can result in pregnancy outcomes, similar to those without AZFcd deletion.

#166 : Investigating the Effect of Parental Age on Intracytoplasmic Sperm Injection Reproductive Outcomes in Indonesia: Prognostic Tools and Prediction Approaches to Maximize Human Embryo Implantation

Background and Aims: Reproductive issues impact one in eight Indonesian married couples. Intra Cytoplasmic Sperm Injection (ICSI) is still expensive; hence many couples don’t get evaluated or enroll fertility programs. We decided to study the correlation between age, hormonal status, and ICSI embryo quality because Indonesia’s infertility rate is rising. This is the first investigation into the factors behind ICSI outcomes in Indonesia. Method: In 2022, two fertility centers in Surabaya and Tangerang, Indonesia, performed ICSI on couples. 150 couples receiving ICSI at two research sites comprise the sample. Surgically retrieved or frozen sperm cycles and incomplete medical records were excluded. The Spearman test was used to investigate the correlation between parental age, hormonal status, and ICSI embryo quality on day 1 and day 3. (D1 and D3). Results: 150 ICSI cycles were studied. The hormonal baseline varied from normal to subnormal, while paternal and maternal age ± SDs were 37.03 ± 6.08 and 34.28 ± 5.11. The Spearman test demonstrated a significant negative connection between paternal age and embryo quality D1 (p&lt;0.005, r=-0.363) and D3 (good category: p&lt;0.005, r=-0.172; intermediate category: p&lt;0.005, r=-0.250; poor category: p&lt;0.005, r=-0.221). The Spearman test showed a significant negative connection between maternal age and embryo quality D1 (p&lt;0.005, r=-0.413) and D3 (good category: p&lt;0.005, r=-0.231; intermediate category: p&lt;0.005, r=-0.294; poor category: p&lt;0.005, r=-0.291). Conclusion: This study reveals that married couples have a substantial impact on their hormonal condition, the rate of fertilization, the quality of D1 and D3 embryos, and the number of embryos generated following ICSI. To increase the success rate of ICSI procedures, it is necessary to maximize fertility at a younger age.

#55 : Ooplasm Diameter as a Predictor for Pre-Implantation Development in Intracytoplasmic Sperm Injection Cycles

Background and Aims: The use of noninvasive measures such as ooplasm diameter (OD) for oocyte evaluation to predict the results of intracytoplasmic sperm injection (ICSI) is of great clinical importance. In this study, we determine whether OD is a significant predictor for pre-implantation development in intracytoplasmic sperm injection cycles in order to select good quality oocytes. Method: A total of 1,130 treatment cycles from 1,130 women who underwent oocyte retrieval during mild stimulation cycles between February 2018 to June 2019 were retrospectively reviewed. The correlation of OD with embryonic outcomes was analyzed. Results: The logistic regression analysis demonstrated that the OD was not correlated with embryonic outcomes. However, our preliminary analysis demonstrated that the embryonic outcomes in the oocytes with small or large OD tended to be lower than those oocytes with optimal OD. Therefore, we stratified the oocytes into six groups according to the OD using statistical software (Group A, OD &lt; 110.19; B 110.19 [Formula: see text] OD &lt; 112.22; C, 112.22 [Formula: see text] OD &lt; 113.67; D, 113.67 [Formula: see text] OD &lt; 115.01; E, 115.01 [Formula: see text] OD &lt; 116.02; F, 116.02 [Formula: see text] OD). The highest blastocyst utilization rate was observed in Group D. The blastocyst utilization rate in Group A (the smallest-diameter group) and F (the largest-diameter group) were significantly lower than that in Group C and D. Conclusion: The optimal range of OD is associated with the higher blastocyst utilization rate after ICSI. These results suggest that OD might be used as a predictive parameter to select/de-select the oocytes for insemination, leading to better control of the quantity and quality of the embryos obtained, reducing to a minimum the ethical issues related to excess embryos.

The importance of sperm DNA fragmentation in the choice of a method for the treatment of male infertility using assisted reproductive technologies

Background. Sperm DNA fragmentation is an important marker of male fertility and may influence the outcome of the infertility treatment based on assisted reproductive technologies. Numerous studies have been done to assess the effect of sperm DNA fragmentation on reproductive outcomes, however the extent of this effect with various assisted reproductive technologies remains a matter of debate.Materials and methods. Search, analysis and systematization of publications in the PubMed and eLIBRARY databases using the keywords: male infertility, sperm DNA fragmentation, intrauterine insemination, in vitro fertilization, intracytoplasmic sperm injection. We have selected 49 sources that are included in this literature review.Results and discussion. The presence of a high level of sperm DNA fragmentation is associated with a low probability of natural pregnancy, as well as a low frequency of successful intrauterine insemination. The high level of sperm DNA fragmentation appears to have a negative impact on the reproductive outcomes of in vitro fertilization and intracytoplasmic sperm injection (ICSI), but the degree of this effect on the results of ICSI is less pronounced. ICSI with testicular spermatozoa can be used in treatment of male infertility associated with high sperm DNA fragmentation, however, the data on the advantage of this approach over standard ICSI are contradictory.Conclusion. High level of sperm DNA fragmentation associated with the low likelihood of natural pregnancy and success of intrauterine insemination and in vitro fertilization. More large, well-designed studies are needed to establish the role of ICSI with testicular sperm in the treatment of patients with high levels of sperm DNA fragmentation.

ICSI outcome after microdissection testicular sperm extraction, testicular sperm aspiration and ejaculated sperm

We conducted a case-controlled single-center cohort study to evaluate the intracytoplasmic sperm injection (ICSI) outcome in severe male infertility with different methods of sperm obtention. The data was compiled from a tertiary university hospital. The micro-TESE procedures were performed from 2008 to 2023, with a sperm recovery rate (SRR) of 45 %. The ICSI treatments were carried out between 2011 and 2023. The aim of the study was to compare the ICSI outcome using sperm obtained by microdissection testicular extraction (micro-TESE), testicular sperm aspiration (TESA), and ejaculated sperm with sperm concentration less than 15 million per milliliter. We included a total of 462 ICSI cycles, of which 340 ICSIs with ejaculated sperm of men with oligozoospermia, with or without asthenozoospermia or teratozoospermia (OAT group), 51 ICSIs with TESA sperm of men with obstructive azoospermia (OA, TESA group), and 71 ICSIs with micro-TESE sperm of men with non-obstructive azoospermia (NOA, micro-TESE group). The patient characteristics, fertilization rate, pregnancy rate, and pregnancy outcome data were similar between the groups. The fertilization rates were 66.0 % in the OAT group, 68.3 % in the TESA group and 62.8 % in the micro-TESE group and live birth rate per embryo transfer were 23.7 %, 28.9 %, and 25.0 %, respectively, without statistical difference. The obstetrical outcome was similar in all the groups. The overall clinical results in all ICSI cycles performed for treating severe male factor infertility were similar, independent of the method of collection of spermatozoa. The results also confirm the efficacy of micro-TESE in the treatment of severe male factor infertility.

Association of methylene tetrahydrofolate reductase polymorphisms with cycle day two hormonal characteristics

The 5,10-methylenetetrahydrofolate reductase (MTHFR) enzyme is a key methionine and folate metabolism enzyme that is found in oocytes and embryos in preimplantation stages and plays a vital role in female reproduction.To assess the impact of MTHFR genetic polymorphisms (C677T and A1298C) on follicular stimulating hormone (FSH), luteinizing hormone(LH), Estradiol (E2), progesterone and antimullerian hormone (AMH) in female receiving intracytoplasmic sperm injection (ICSI), 85 infertile women undergoing ICSI treatment at the High Institute of Infertility Diagnosis and Assisted Reproductive Technologies in Baghdad, Iraq, were recruited. These patients had their MTHFR polymorphism genotypes examined, FSH, LH, E2, progesterone, and AMH levels were compared between groups. Furthermore, all demographic characteristics as well as ICSI outcomes were compared between pregnant and non-pregnant women. The research revealed no discernible variation between the means of FSH, LH, E2 and AMH with respect to the 219A&gt;C(rs1801131) (A1298C) genotypes (p &gt; 0.05). Progesterone level was significantly differed with high level found in CC followed by AA and AC. There was no statistically significant variation in hormonal features between CC, CT, and TT for A1298C, 219A&gt;C(rs1801133). The demographic features (age, duration, type of infertility, cause of infertility and previous trial) were not notably different between women who were pregnant and those who were not. In women undergoing ICSI, the maternal MTHFR polymorphisms is not related to FSH, LH, E2 and AMH. MTHFR polymorphisms therefore don't offer useful information regarding the hormonal levels in our groups

The Potential of Theophylline and Pentoxifylline in Sperm Optimization and Its Intracytoplasmic Sperm Injection Outcomes.

Sperm motility is an essentialselection criteria by embryologists at the time of intracytoplasmic sperm injection (ICSI). One method of testing sperm viability is to induce sperm motility by increasing cyclic adenosine monophosphate (cAMP) levels by treating a semen sample with phosphodiesterase inhibitors (PDEIs), such as theophylline and pentoxifylline. It explores the implications of PDEI in medical care, reflecting on its effects in clinical settingsand recognizing potential topics for future exploration. This analysis revealed that by incorporating stimulants that activate movements, the time it took to single out sperms was markedly reduced, and consequently, the sperms were safeguarded from a prolonged period of oxidative stress. Furthermore, theophylline was found to advance sperm motility, consequently resulting in several initially immobile spermatozoa displaying rapid progressive motility. Higher fertilization rate, cleavage rate, good quality embryos (grade I), and higher biochemical and clinical pregnancy rates were found with artificial sperm activation (ASA) using pentoxifylline and theophylline. This review emphasizes the need for more research to evaluate the drug's long-term safety and investigate the effects of theophylline and pentoxifylline on postfertilization parameters, such as embryo development, implantation, and pregnancy outcomes. These areas of investigation are important for understanding the complete impact of these agents and to ensure their safe and effective implementation in clinical practice.

Effect of ejaculatory abstinence period on fertilization and clinical outcomes in ICSI cycles: a retrospective analysis

Does ejaculatory abstinence impact fertilization outcomes in intracytoplasmic sperm injection (ICSI) cycles in infertile couples? This single-centre retrospective observational study included 6919 ICSI cycles from 2013 to 2022. The primary outcome was the assessment of oocyte fertilization, measured in terms of the rate of formation of two-pronuclear (2PN), 3PN and 1PN zygotes. Secondary outcomes were blastulation, cumulative positive β-human chorionic gonadotrophin test and clinical pregnancy rates. Relationships between ejaculatory abstinence and fertilization outcomes, and ejaculatory abstinence and clinical outcomes were evaluated with multivariable analysis, including possible confounders. A positive association was observed between ejaculatory abstinence and semen sample volume (P < 0.001), sperm concentration (P < 0.001) and total motile sperm count (P < 0.001). No association was found between the 1PN zygote rate and ejaculatory abstinence (P = 0.97). Conversely, for each additional day of ejaculatory abstinence, the likelihood of obtaining 2PN zygotes from all inseminated oocytes decreased by 3% [adjusted odds ratio (aOR) 0.97, 95% CI 0.94-0.99], whilst the likelihood of obtaining 3PN zygotes from all inseminated oocytes increased significantly by 14% (aOR 1.14, 95% CI 1.07-1.22). No significant associations were found between ejaculatory abstinence and blastulation, cumulative pregnancy or miscarriage rates. A longer ejaculatory abstinence period significantly decreases the rate of 2PN zygotes, and increases the rate of 3PN zygotes without directly affect blastulation and pregnancy rates.

Association between Anti-Sperm Antibody and Intra-cytoplasmic Sperm Injection Outcomes Among Male Infertility Patients

Background: Infertility, a clinical and public concern, affects both social life and the health system. Sperm abnormalities which include (Oligozoospermia), (teratozoospermia) or abnormalities related to sperm motility are essential factors in male infertility. Anti-sperm antibodies (ASA) are the leading cause of immune infertility in men (autoimmune disease). Intra-cytoplasmic Sperm Injection (ICSI) is specially designed to manage severe cases of male-factor infertility. this study aimed to determine the effect of ASA on ICSI outcomes among Normospermia and (Oligozoospermia, Asthenozoospermia and Teratozoospermia). Material and methods: This is a cross-sectional study performed at Fertility Center, Najaf-Iraq between Jan to June 2023, it included 50 couples who suffered from a minimum of 12 months of primary fertility who had attended the Fertility Center. They were divided into four groups (Normospermia, Oligospermia, Teratozoospermia, and Asthenospermia) according to their seminal fluid analysis (SFA). Sperms were collected by ICSA, immobilized, and processed. The oocytes were collected, injected, and prepared for fertilization , after that fertilization took place. Finally, pregnancy was examined in each female partner. Results: there was no significant difference in the age of the four groups, there was no relationship between ASA and Sperm concentration, and there was no relationship between ASA and Normal Sperm Morphology, fertilization , &amp; pregnancy rates, in addition to other ICSI outcomes, were similar among the four groups.in conclusion, pregnancy rates were higher in the normospermia group than the other three groups and ICSI overcomed the presence of ASA in the semen plasma.

LH on GnRH-ant day to basal LH affects the IVF/ICSI outcome of PCOS women undergoing GnRH-antagonist protocol.

The aim of this study was to investigate the influence of ratio of serum luteinizing hormone (LH) on gonadotropin-releasing hormone antagonist (GnRH-ant) day to basal LH (hLH/bLH) on in-vitro fertilization or intracytoplasmic sperm injection (IVF/ICSI) outcome in polycystic ovary syndrome (PCOS) women who received GnRH-ant protocol for controlled ovarian hyperstimulation (COH). This retrospective study was conducted in women with PCOS (n = 1116) who underwent the GnRH-ant protocol for COH between 2015 and 2022 and were stratified as group A (hLH/bLH < 1, n = 489) and group B (hLH/bLH ≥ 1, n = 627) according to the variation of serum LH. The outcomes of COH and the first frozen embryo transfer (FET) cycle were compared between group A, B and the linear relationship between hLH/bLH ratio and IVF/ICSI outcomes were studied by multivariate linear regression analysis and restricted cubic spline (RCS) models. There were significant differences in baseline characteristics and outcomes between group A and B. Group A had higher levels of bLH, AMH, estradiol (E2) on GnRH-ant start day and lower levels of LH on GnRH-ant start day. Group B has better ovulation induction outcomes: more retrieved oocytes, normally fertilized oocytes (2PN), cleavage embryos, available embryos and high-quality blastocysts. Multivariate linear regression analysis found no statistically significant connection between hLH/bLH and clinical outcomes. RCS models showed hLH/bLH had nonlinear association with outcomes, including number of oocytes retrieved, 2PN, available embryos, incidence of OHSS, chemical pregnancy, clinical pregnancy, abortion and live birth. hLH/bLH ratio could be a more forward-looking indicator of clinical outcome in women with PCOS undergoing GnRH-ant protocols than LH on trigger day and the ratio of LH level on trigger day to basal LH. hLH/bLH = 1 may be the best condition for higher live birth rate and lower OHSS rate.