Intracytoplasmic Sperm Injection Treatment Research Articles

Decreased Sperm Motility Retarded ICSI Fertilization Rate in Severe Oligozoospermia but Good-Quality Embryo Transfer Had Achieved the Prospective Clinical Outcomes.

IntroductionSpermatozoa motility is the critical parameter to affect the treatment outcomes during assisted reproductive technologies (ART), but its reproductive capability remains a little informed in condition of severe male factor infertility. This retrospective cohort study aimed to evaluate the effects of reduced sperm motility on the embryological and clinical outcomes in intra-cytoplasmic sperm injection (ICSI) treatment of severe oligozoospermia.Patients and Methods966 cycles (812 couples) of severe oligozoospermia diagnosed by spermatozoa count ≤ 5 × 106/mL and motile spermatozoa ≤ 2 × 106/mL were divided into four groups in according to the number of motile spermatozoa in one ejaculate on the day of oocyte retrieval (Group B—E). The control (Group A) was 188 cycles of moderate oligozoospermia with spermatozoa count > 5 × 106/mL and motile spermatozoa > 2 × 106/mL. All female partners were younger than 35 years of age. Logistic regression analyzed embryological outcomes (the rates of fertilization, cleavage and good-quality embryo) and clinical outcomes (the rates of pregnancy, implantation, early miscarriage and live birth). Quality of embryo transfer (ET) was divided into three classes as continuous factor to test the effects of embryo quality on clinical outcomes.ResultsThe reduction in the number of motile sperm in four groups of severe oligozoospermia gave rise to comparable inability of the fertilization (p < 0.001) and a decreased rate of good-quality embryo at Day 3 (p < 0.001) by compared to the control. The cleavage rate of the derived zygotes was similar to the control. ET classes significantly affected the clinical outcomes (p < 0.001). Class I ET gave rise to similar rates of clinical outcomes between five groups, but Class II and Class III ET retarded the rates of pregnancy, implantation and live birth and this particularly occurred in Group C, D and E. The rate of early miscarriage was not comparably different between groups. Overall rates in all groups were 41.26% clinical pregnancy, 25.74% implantation and 36.32% live birth, which gave live birth to 252 girls and 252 boys.ConclusionsThe reduction of motile spermatozoa in severe oligozoospermia decreased the rates of fertilization and good-quality embryo. Obtaining and transfer of good-quality embryos was the good prognostic to achieve prospective clinical outcomes regardless of the severity of oligozoospermia.

Effect of ethnicity on live birth rates after invitro fertilisation/intracytoplasmic sperm injection treatment: analysis of UK national database.

To evaluate the effect of ethnicity of women on the outcome of invitro fertilisation (IVF) or intracytoplasmic sperm injection (ICSI) treatment. Observational cohort study. UK National Database. Data from 2000 to 2010 involving 38709 women undergoing their first IVF/ICSI cycle were analysed. Anonymous data were obtained from the Human Fertilization and Embryology Authority (HFEA), the statutory regulator of IVF and ICSI treatment in the UK. Data analysis was performed by regression analysis with adjustment for age, cause and type of infertility and treatment type (IVF or ICSI) to express results as odds ratio (OR) and 95% confidence intervals (95% CI). Live birth rate per cycle of IVF or ICSI treatment. While white Irish (OR 0.73; 95% CI 0.60-0.90), Indian (0.85; 0.75-0.97), Bangladeshi (0.53: 0.33-0.85), Pakistani (0.68; 0.58-0.80), Black African (0.60; 0.51-0.72), and other non-Caucasian Asian (0.86; 0.73-0.99) had a significantly lower odds of live birth rates per fresh IVF/ICSI cycle than White British women, ethnic groups of White European (1.04; 0.96-1.13), Chinese (1.12; 0.77-1.64), Black Caribbean (0.76; 0.51-1.13), Middle Eastern (0.73; 0.51-1.04), Mediterranean European (1.18; 0.83-1.70) and Mixed race population (0.94; 0.73-1.19) had live birth rates that did not differ significantly. The cumulative live birth rates showed similar patterns across different ethnic groups. Ethnicity is a major determinant of IVF/ICSI treatment outcome as indicated by significantly lower live birth rates in some of the ethnic minority groups compared with white British women. Ethnicity affects IVF outcome with lower live birth rates in some ethnic groups more than in white British.

The effect of endometrial polyps on pregnancy rates in intracytoplasmic sperm injection cycles

Objective: The purpose of this study was to determine reproductive results of intracytoplasmic sperm injection (ICSI) for different endometrial polyps subgroup divided according to polyp size and number. Materials and Methods: Eighty-three primer infertile patients were retrospectively analyzed. Group A consisted of 36 patients having an endometrial polyp with a diameter ≤ one cm; whereas 47 patients were included in Group B who had a polyp with a diameter > one cm or more than one polyps. All patients underwent a hysteroscopic polypectomy and ICSI treatments were started in the following cycle. Results: Pregnancy was achieved in 16 patients (44.4%) in Group A and 23 patients (48.9%) in Group B. The pregnancy ratios did not reveal a statistically significant difference between the two groups. Conclusion: The authors concluded that in patients who have undergone hysteroscopic polypectomy before the intracytoplasmic sperm injection (ICSI) cycle, the pregnancy rates do not depend on the diameter of the endometrial polyps.

Infertile men’s needs and assessment of fertility care

Introduction: Male infertility is potentially a severe, low-control stressor. There is limited knowledge of the expectations, needs, and assessment of fertility care among men with severe infertility. The aim of this study was to explore experience, expectations, needs, and assessment of fertility care among Danish men having severe male-factor infertility.Methods: Semi-structured qualitative interview study with 10 men with very low sperm quality initiating intracytoplasmic sperm injection (ICSI) treatment at the Fertility Clinic, Copenhagen University Hospital, Hvidovre, Denmark. Five of the men participated in a follow-up interview after their first ICSI treatment. The data collection took place during November 2014 to May 2015. Data were analysed using qualitative content analysis.Results: Two themes were found: ‘The maze’ and ‘Desire for care’. It felt like an eternity for the men from the referral until treatment started. The men did not understand the process, and it was like being in a maze. The men saw fatherhood as something to strive for. They felt that they could not do what a man is supposed to do, and they felt pushed aside and that treatment focused on the women. The men appreciated the staff’s kindness and professionalism but desired the staff to address emotional subjects too.Conclusion: The process from referral to treatment felt like a maze for these men. They needed the staff to give them the opportunity to speak of the psychosocial consequences of severe male-factor infertility.

Ultrastructural and cytogenetic analyses of mature human oocyte dysmorphisms with respect to clinical outcomes.

The study aimed to describe the ultrastructure of two human mature oocyte intracytoplasmic dysmorphisms, the bull-eye inclusion and the granular vacuole, with evaluation of clinical outcomes after intracytoplasmic sperm injection (ICSI) treatment. We retrospectively evaluated 4099 consecutive ICSI cycles during the period 2003-2013. Three groups were compared: controls, those with a bulls-eye inclusion, and those with granular vacuoles. Oocyte dysmorphisms were evaluated by transmission electron microscopy and in situ fluorescence hybridization (FISH). Detailed data on demographic and stimulation characteristics, as well as on embryological, clinical, and newborn outcomes, are fully presented. The bull-eye inclusion is a prominent smooth round structure containing trapped vesicles, being surrounded by lipid droplets. The presence of this dysmorphism in the oocyte cohort had no clinical impact except when transferred embryos were exclusively derived from dysmorphism oocytes. The granular vacuole is delimited by a discontinuous double membrane and contains lipid droplets and vesicles. As FISH analysis revealed the presence of chromosomes, they probably represent pyknotic nuclei. The presence of this dysmorphism in the oocyte cohort had no clinical impact except when at least one transferred embryo was derived from dimorphic oocytes. Poor clinical outcomes were observed with transfer of embryos derived from dysmorphism oocytes, although without causing gestation or newborn problems. The bull-eye inclusion and granular vacuoles may thus be new prognostic factors for clinical outcomes.

Men becoming fathers by intracytoplasmic sperm injection were more often born small for gestational age.

Being born with nonoptimal birth characteristics decreases the chance of becoming a father. Urogenital malformations as well as metabolic syndrome are more common in men born small for gestational age (SGA) and could be contributing factors to the reduced fertility rate seen in these men. It could imply that men becoming fathers by assisted reproductive technology (ART) more often are born with low birth weight (LBW), preterm, and/or SGA than men conceiving without treatment and also that men where intracytoplasmic sperm injection (ICSI) had to be performed more often are born with nonoptimal birth characteristics than men where conventional in vitro fertilization (IVF) successfully could be used. In this retrospective, case–control study using Swedish national registers, we compared the birth characteristics of 1206 men who have become fathers by ART with a control group consisting of age-matched men who became fathers without treatment. The differences in birth characteristics between men becoming fathers by IVF and ICSI were also assessed. For men becoming fathers by ART, OR of being born with LBW was 1.66 (95% CI = 1.17–2.36) compared with fathers who conceived without treatment. OR of being born prematurely was 1.32 (95% CI = 1.00–1.77). Men becoming fathers via ICSI had a doubled increased likelihood of being born SGA compared with men who became fathers via IVF (OR = 2.12; 95% CI = 1.17–3.83). In conclusion, we have found that men becoming fathers by ICSI treatments had more often been born SGA than men becoming fathers by conventional IVF.

The Value of Routine Hysteroscopy before the First Intracytoplasmic Sperm Injection Treatment Cycle

Background/Aims: To assess uterine cavity with office hysteroscopy in order to diagnose and treat pathologies in patients who have started their first intracytoplasmic sperm injection (ICSI) cycles and evaluate its impact on pregnancy rate. Methods: A number of 220 infertile women scheduled for ICSI participated in this prospective randomized study. They were randomly divided into 2 equal groups. Group I (intervention) underwent office hysteroscopy before starting assisted reproductive techniques (ART) cycle. Group II (control) started ART cycles without office hysteroscopy. All women had normal transvaginal ultrasonography and hysterosalpingography. The detected intrauterine abnormalities were treated during hysteroscopy. Four weeks after embryo transfer, ultrasonography was done for detecting clinical pregnancy. Results: Abnormal findings were seen in hysteroscopy in 22.7% of the intervention group. The pregnancy rate in the intervention group (48.20%) was significantly higher than that in the control group (38.60%; p = 0.004). Conclusion: Routine office hysteroscopy before ICSI cycles provides direct evaluation of uterine cavity. Also, pregnancy rate improves after correction of endometrial cavity abnormalities.

Flexibility in starting ovarian stimulation at different phases of the menstrual cycle for treatment of infertile women with the use of in vitro fertilization or intracytoplasmic sperm injection

To investigate flexibility in starting controlled ovarian stimulation at any phase of the menstrual cycle in infertile women undergoing treatment with assisted reproduction. Retrospective cohort study. Academic tertiary-care medical center. At total of 150 infertile patients undergoing invitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI) treatment. Ninety of the women also underwent frozen embryo transfer (FET) procedures. Depending on the phase of the menstrual cycle when ovarian stimulation was started, three groups of patients were identified, namely: conventional group (ovarian stimulation started in the early follicular phase), late follicular phase group, and luteal phase group. When dominant follicles were observed, final oocyte maturation was triggered with the use of GnRH agonist and hCG. In all three groups, viable embryos were cryopreserved for subsequent transfer. number of mature oocytes retrieved. fertilization rate, viable embryo rate per oocyte retrieved, cancellation rate, and clinical pregnancy outcomes from FET cycles. There were no differences in the mean number of mature oocytes retrieved in the conventional group, late follicular phase group, and luteal phase group (5.7 ± 3.6, 5.2 ± 3.7, and 5.2 ± 3.9, respectively). Similarly, no significant differences were observed in the viable embryo rate per oocyte retrieved (37.9%, 38.5%, and 43.6%), clinical pregnancy rates (41.5%, 45.5%, and 38.9%), and implantation rates (30.7%, 30.2%, and 27.1%) in the three groups. All three ovarian stimulation protocols were observed to be equally effective. These results demonstrate that ovarian stimulation can be commenced on any day of the menstrual cycle. ChiCTR-OPN-15007332.

Effect of polycystic ovaries on in vitro fertilization and intra-cytoplasmic sperm injection treatment outcome

Abstract Objective The reproductive performance of women with polycystic ovaries (PCO) with regular ovulatory menstrual cycles undergoing in vitro fertilization and intra-cytoplasmic sperm injection (IVF/ICSI) treatment has not been well described. This study aimed to investigate the outcome of IVF/ICSI in ovulatory women with PCO. Methods A retrospective cohort study of women aged ≤ 42 years with infertility and regular ovulatory menstrual cycles who underwent their first IVF/ICSI cycle using the long down regulation protocol at IVF Australia-EAST in Sydney between 2000 and 2011. A pre-treatment baseline transvaginal pelvic ultrasound (TVS) had been performed by a single tertiary level diagnostic ultrasound center. Patients were divided into either group NO (normal ovaries) or group PCO according to the pre-treatment TVS. The primary outcome measure was live birth rate per patient. Results A total of 200 patients (135 in group NO and 65 in group PCO) were included in the data analysis. There was no difference in live birth rate per patient between the two groups (25.2% vs 26.2%) with both raw ( OR [95% CI ] = 1.05 [0.54–2.07]) and logistic regression adjusted (for maternal age) (Adjusted OR [95% CI ] = 0.99 [0.50–1.98]) data. Conclusions The presence of PCO in ovulatory women did not adversely affect IVF/ICSI outcome at our unit. However, the results are not conclusive and further large, well-designed prospective cohort studies are required in order to confirm our findings.

First line fertility treatment strategies regarding IUI and IVF require clinical evidence.

The advent of intracytoplasmic sperm injection (ICSI) has contributed to a significant growth in the delivery of assisted conception technique, such that IVF/ICSI procedures are now recommended over other interventions. Even the UK National Institute for Health Care Excellence (NICE) guidelines controversially recommends against intrauterine insemination (IUI) procedures in favour of IVF. We reflect on some of the clinical, economic, financial and ethical realities that have been used to selectively promote IVF over IUI, which is less intrusive and more patient friendly, obviates the need for embryo storage and has a global application. The evidence strongly favours IUI over IVF in selected couples and national funding strategies should include IUI treatment options. IUI, practised optimally as a first line treatment in up to six cycles, would also ease the pressures on public funds to allow the provision of up to three IVF cycles for couple who need it. Fertility clinics should also strive towards ISO15189 accreditation standards for basic semen diagnosis for male infertility used to triage ICSI treatment, to reduce the over-diagnosis of severe male factor infertility. Importantly, there is a need to develop global guidelines on inclusion policies for IVF/ICSI procedures. These suggestions are an ethically sound basis for constructing the provision of publicly funded fertility treatments.

Predicting suitable timing for artificial reproductive technology treatment in aged infertile women.

It has been widely accepted that the age of women plays a fundamental role in fecundity, and age-related fertility decline has one of the most significant and detrimental effects on the success rate of infertility treatment. Therefore, treatment cycles of non-in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI) treatment for infertile women of advanced aged have been limited due to their lack of efficacy, and they are often optimized, compared to IVF/ICSI treatment. Recent trends in infertility treatment apparently indicate that IVF/ICSI treatment, including egg donation, is frequently offered to aged women for first-line management, despite its heavy burden, but hasty IVF/ICSI treatment should be avoided, considering its socioeconomic problems. It is important to distinguish women who could conceive by non-IVF/ICSI treatment, although the optimization of non-IVF/ICSI treatment protocols remains poorly understood. This review focuses on extracting aged patients who have higher chance of conceiving with non-IVF/ICSI treatment and providing necessary and sufficient infertility treatment. After initial evaluation for fertility, including tubal factor, male factor, the presence of endometriosis and/or adenomyosis, and ovarian reserve, the outcomes of fertility treatment can be predicted to some extent in aged infertile women.

Differential effects of short co-incubation of gametes and early removal of cumulus cells in patients with different fertilizing capabilities

The objective of this retrospective study was to evaluate the embryological and clinical outcomes of short co-incubation of gametes and early removal of cumulus cells (SCGERCC) in patients with good IVF capability and those with complete fertilization failure treated by rescue intracytoplasmic sperm injection (ICSI). The study included 257 couples with >60% fertilization rate (SCGERCC group) in the SCGERCC cycle, 72 couples with complete fertilization failure in the SCGERCC cycle given early rescue ICSI treatment (early rescue group), and 219 couples who underwent IVF cycles with overnight co-incubation of gametes with >60% fertilization rate (traditional IVF group). The results showed that the SCGERCC group had a higher multi-pronuclei rate (13.34%, P < 0.001) than the early rescue ICSI (5.15%) and traditional IVF (6.15%) groups. The good quality embryo rate was higher in the SCGERCC group, but implantation, clinical pregnancy and live-birth rates (37.21%, 36.92% and 38.20% for SCGERCC, early rescue and traditional IVF groups, respectively) were comparable in all three groups. The study indicated that SCGERCC followed by rescue ICSI helped couples with initial complete fertilization failure attain clinical outcomes comparable with the other two groups, but it significantly increased the multi-pronuclei rate in couples with good fertilizing capabilities.

Comparison of Frequency and Intensity of Stressors in Infertile Couples Undergoing Intrauterine Insemination Treatment, Intra-Cytoplasmic Sperm Injection Treatment and without Treatment

Introduction: Infertility is a personal crisis. There are different assisted reproductive techniques in the treatment of infertility. Anxiety and stress have been shown to be markedly higher in infertile couples. This study was aimed to compare the frequency and intensity of stressors in infertile couples undergoing intrauterine insemination (IUI) treatment, Intra-cytoplasmic sperm injection (ICSI) treatment and without treatment (control group). Materials and Methods: Thirty seven infertile couples undergoing IUI, ICSI and without treatment were selected by non-random convenient sampling from the cases admitted to Rooyan Infertility Clinic. They completed demographic information sheet, and the Stressors Scale. Results: The results showed that there was no significant correlation between duration of infertility with frequency and intensity of stressors. There was no significant correlation between frequency and intensity of stressors with infertility factors. There was also no significant difference in the frequency and intensity of stressors between men and women. There were no differences in the frequency and intensity of stressors between ICSI and IUI with control group. Data showed that there was a significant difference in the frequency of stressors with the group of IUI treatment as well as in the frequency of stressors between ICSI and IUI with control group. Findings demonstrated that there was significant difference between IUI with and without ICSI groups in the frequency and intensity of stress. Conclusion: IUI, ICSI and control groups as the assisted reproductive techniques can be stressful. Long-term planning of mental health services for infertile couples, identifying couples at risk, convincing couples to refer for psychological assessment, psychotherapy by clinical psychologists, and drug therapy by psychiatrists are suggested.

The value of Anti-Müllerian hormone in low and extremely low ovarian reserve in relation to live birth after in vitro fertilization

ObjectiveTo determine the relation of Anti-Müllerian hormone (AMH) with live birth after in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI) in women with (extremely) low ovarian reserve. Study designThis study was a retrospective cohort study in a Dutch tertiary fertility clinic. Between January 2009 and March 2012, AMH levels were measured in infertile women when ≥36 years of age or when showing clinical signs of diminished ovarian reserve, before they underwent IVF or ICSI treatment. Ultimately, 156 women with (extremely) low ovarian reserve were included and evaluated for cumulative live birth rates. Of each woman, only one treatment cycle was analyzed, either the one in which she became pregnant or her first treatment cycle if she did not reach pregnancy. The relation between AMH and live birth was evaluated with multivariable logistic regression analysis. A ROC curve was composed to evaluate the discriminative value of AMH in relation to live birth after IVF/ICSI. ResultsThirty-three out of 156 women (21.2%) gave live birth. Live birth was significantly lower in women with AMH ≤0.1ng/ml (4/37 women; 10.8%) or AMH >0.1–0.4ng/ml (7/42 women; 16.7%), compared to women with AMH >0.4–1.05ng/ml (22/77 women; 28.6%), p<0.001. Multivariable logistic regression revealed an association between the severity of low ovarian reserve and live birth (per 0.1ng/ml increase in AMH value, Odds ratio 1.21; 95% CI 1.07–1.36). ConclusionsThe level of AMH is related to live birth after IVF/ICSI in women with (extremely) low ovarian reserve. The live birth rate in women with AMH >0.4ng/ml was significantly higher than in women with AMH ≤0.4ng/ml. AMH could serve as a tool in the pre-treatment counseling for pregnancy and live birth chances in women with (extremely) low ovarian reserve.

Medical Cosmopolitanism in Global Dubai: A Twenty-first-century Transnational Intracytoplasmic Sperm Injection (ICSI) Depot.

Dubai-one of the seven United Arab Emirates and the Middle East's only "global city"-is gaining a reputation as a transnational medical tourism hub. Characterized by its "medical cosmopolitanism," Dubai is now attracting medical travelers from around the world, some of whom are seeking assisted conception. Dubai is fast becoming known as a new transnational "reprohub" for intracytoplasmic sperm injection (ICSI), the variant of in vitro fertilization designed to overcome male infertility. Based on ethnographic research conducted in one of the country's most cosmopolitan clinics, this article explores the ICSI treatment quests of infertile men coming to Dubai from scores of other nations. The case of an infertile British-Moroccan man is highlighted to demonstrate why ICSI is a particularly compelling "masculine hope technology" for infertile Muslim men. Thus, Muslim men who face barriers to ICSI access in their home countries may become "reprotravelers" to Dubai, an emergent ICSI depot.

A novel micro-straw for cryopreservation of small number of human spermatozoon.

Cryopreservation of few spermatozoa is still a major challenge for male fertility preservation. This study reports use a new micro-straw (LSL straw) for freezing few spermatozoa for intracytoplasmic sperm injection (ICSI). Semen samples from 22 fertile donors were collected, and each semen sample was diluted and mixed with cryoprotectant in a ratio of 1:1, and then frozen using three different straws such as LSL straw (50–100 μl), traditional 0.25 ml and 0.5 ml straws. For freezing, all straws were fumigated with liquid nitrogen, with temperature directly reducing to −130–−140°C. Sperm concentration, progressive motility, morphology, acrosome integrity, and DNA fragmentation index were evaluated before and after freezing. After freezing-thawing, LSL straw group had significantly higher percentage of sperm motility than traditional 0.25 ml and 0.5 ml straw groups (38.5% vs 27.4% and 25.6%, P < 0.003). Sperm motility and acrosomal integrity after freezing-thawing were significantly lower than that of before freezing. However, there was no significant difference in morphology, acrosome, and DNA integrity between the three types of straws (P > 0.05). As LSL straws were thinner and hold very small volume, the freezing rate of LSL straw was obviously faster than 0.25 ml straw and 0.5 ml straws. In conclusion, LSL micro-straws may be useful to store few motile spermatozoa with good recovery of motility for patients undergoing ICSI treatment.

The Role of Interleukin-18 in Serum and Follicular Fluid during In Vitro Fertilization and Intracytoplasmic Sperm Injection.

Cytokines are key modulators of the immune system and play an important role in the ovarian cycle. IL-18 levels in serum and follicular fluid were analyzed in women undergoing in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI) treatment. The cohort study group consisted of 90 women, who were undergoing IVF or ICSI. The body mass index (BMI) was determined in all patients; IL-18 levels were measured in follicular fluid and serum. IL-18 levels in serum were significantly higher than those in follicular fluid. The median level in serum was 162.75 (80.21) pg/mL and that in follicular fluid, 138.24 (91.78) pg/mL. Women undergoing IVF treatment had lower IL-18 levels in serum (median, 151.19 (90.73) pg/mL) than those treated with ICSI (median, 163.57 (89.97) pg/mL). The correlation between IL-18 levels in serum and BMI was statistically significant, as well as the correlation between IL-18 levels in follicular fluid and ovarian stimulation response (p = 0.003). IL-18 was correlated with the response to ovarian stimulation and was the reason for successful pregnancy after IVF or ICSI treatment. Among other cytokines, IL-18 appears to be a promising prognostic marker of success in reproductive treatment and should be evaluated as such in further prospective studies.

Comparison of pregnancy rate between fresh embryo transfers and frozen-thawed embryo transfers following ICSI treatment

The use of assisted reproductive technology (ART) is increasing in the world. The rate, efficacy and safety of ART are very different among countries. There is an increase in the use of intra cytoplasmic sperm injection (ICSI), single fresh embryo transfer (ET) and frozen-thawed embryo transfer (FET). The objective of this study was to compare pregnancy rate in fresh ET and FET. In this retrospective cross-sectional study 1014 ICSI-ET cycles (426 fresh ET and 588 FET) from 753 women undergoing ICSI treatment referred to Fatemezahra Infertility and Reproductive Health Research Center in Babol, Iran from 2008 to 2013 were reviewed. There were no significant differences between biochemical pregnancy rate (23% versus 18.8%, OR 1.301; 95% CI .95-1.774), gestational sac (95.6% versus 100% in FET, OR 0.60; 95% CI 0.54-0.67), and fetal heart activity (87.2% versus 93.6% OR .46; 95% CI .16-1.32) in fresh ET and FET cycles, respectively. P< 0.05 was considered statistically significant for all measures. Although, the result showed no significantly difference between the fresh ET and the FET cycles, however the embryos are able to be stored for subsequent ART. Therefore, we recommend FET cycles as an option alongside the fresh ET.

A new micro swim-up procedure for sperm preparation in ICSI treatments: preliminary microbiological testing.

ObjectiveThis study aimed to assess the levels of microbial contamination in semen samples before and after the micro swim-up (MSU) procedure in intra-cytoplasmic sperm injection (ICSI). The new method is an upgrade to the classic wash swim-up procedure.MethodsSemen analysis and microbiological tests were carried out before and after the MSU procedure. A total of twenty semen samples were analyzed.ResultsPathogens were observed in semen samples only before MSU and never after ICSI. Microbiological tests revealed a large prevalence of gram-positive cocci [Staphylococcus spp. (n=16, 80%) and viridans streptococci (n=10, 50%)]. The results of this study indicate that direct MSU in ICSI improved the ICSI workflow.ConclusionThe new workflow is faster and more affordable, and is likely to prevent infection problems that could arise from the normal microbial flora of the semen.

The Role of Saline Sonohysterography Prior to IVF/ICSI and its Impact on Assisted Reproduction Program Outcome in Egyptian Community

Aim: To assess the incidence of undiagnosed intrauterine pathology based on saline sonohysterography in women with normal transvaginal ultrasound and their impact on the success rate of Intracytoplasmic sperm injection in Egyptian community. Patients and methods: Two hundred qualified patients scheduled for first time Intracytoplasmic sperm injection treatment were divided into 2 groups each containing 100 patients. Group 1 did saline sonohysterography and cases with intrauterine lesions were treated by hysteroscopy prior to undergoing Intracytoplasmic sperm injection, while group 2 did Intracytoplasmic sperm injection without prior saline sonohysterography. The main outcome measures were undiagnosed intrauterine abnormalities as uterine anomalies and polyps, in addition to, pregnancy, miscarriage and on-going pregnancy rates. Results: Uterine lesions were found in 35% of cases undergoing sonohysterography, and 27 out of the 35 cases were treated by hysteroscopy. A significant difference in pregnancy rate and on-going pregnancy rate in favour of the sonohysterography group (P=0.04) and (P=0.031) respectively. Conclusion: Saline sonohysterography is a non-invasive method for the diagnosis of uterine abnormalities improving the outcome of IVF/ICSI cycles.