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Intracytoplasmic Sperm Injection (intracytoplasmic + sperm_injection)

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Urology	12%
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4 Other Subdomains	22%

Selected Abstracts

Intracytoplasmic sperm injection as a complement to gonadotrophin treatment in infertile men with hypogonadotrophic hypogonadism

INTERNATIONAL JOURNAL OF ANDROLOGY, Issue 4 2005
BRANKO ZORN
Summary In this study we sought to determine whether intracytoplasmic sperm injection (ICSI) could improve the efficacy of treatment with gonadotrophins in gonadotrophin-deficient men in terms of pregnancy. A series of six adult men (aged 26,47 years) with hypogonadotrophic hypogonadism (HH) is reported: four men with prepubertal isolated idiopathic HH (IIHH) and two adult-onset HH, as part of hypopituitarism secondary to surgical treatment of a pituitary tumour. All were azoospermic. To restore spermatogenesis, all received hormonal treatment with intramuscular human menopausal gonadotrophins (HMG) and human chorionic gonadotrophin (HCG) for 2 to 23 months. High basal serum inhibin B was predictive of rapid and complete recovery of spermatogenesis. In the two adult-onset HH, a natural pregnancy was achieved within 3 months. The four men with IIHH underwent ICSI because of poor sperm quality. ICSI using fresh or frozen-thawed ejaculated spermatozoa was performed after 6,23 months of gonadotrophin treatment. ICSI provided good clinical results in terms of fertilization and embryo quality, and resulted in three pregnancies that ended in three term deliveries. In men with oligozoospermia related to prepubertal IIHH, ICSI shortens the hormonal treatment and enhances the chances of pregnancy. [source]

Robust computer-controlled system for intracytoplasmic sperm injection and subsequent cell electro-activation

THE INTERNATIONAL JOURNAL OF MEDICAL ROBOTICS AND COMPUTER ASSISTED SURGERY, Issue 1 2009
K. K. Tan
Abstract Introduction Intracytoplasmic sperm injection (ICSI) and the subsequent cell electro-activation process is a relatively new enhanced procedure to address male factor infertility. The current method involves the engagement of experienced embryologists for such a purpose. More advanced methodologies, which use high precision instrumentation tools, will speed up the whole procedure. Methods In this paper, the development of a computer-controlled system for ICSI and the subsequent cell electro-activation process is presented. The system is integrated to a microinjection workstation and piezo-actuator to perform the ICSI procedure, with vision capability to automatically position the components precisely. A micro-pump assembly is utilized for automatic medium refreshment and a heater plate assembly provides temperature control during the cell electro-activation process. The overall system is comprehensive, comprising modular functional components integrated within a hardware architecture. Results Experimental results on mice oocytes verified the effectiveness of the developed system over the current method. Conclusions Further improvements on the instrumentation tools will improve the robustness and overall performance of the developed system. Copyright © 2009 John Wiley & Sons, Ltd. [source]

Intracytoplasmic sperm injection with motile and immotile frozen-thawed testicular spermatozoa (the Hungarian experience)

ANDROLOGIA, Issue 1 2005
Sz. Mátyás
Summary The authors summarize their experience in 75 in vitro fertilization cycles, where frozen-thawed testicular spermatozoa were used for intracytoplasmic sperm injection. In 32 cases, motile spermatozoa could be observed in the frozen-thawed sample. In 34 cases, motility could be induced by pentoxifylline and in nine cases immotile spermatozoa, selected with hypoosmotic swelling test, were used for fertilization. The fertilization rates obtained with motile and immotile spermatozoa (66.1% versus 52.3%) were not significantly different. Our data demonstrate that freezing of testicular spermatozoa opened new possibilities for the treatment of azoospermic men. The clinical pregnancy rate per embryo transfer (ET) (21.87%) was comparable with previous results use of fresh testicular spermatozoa (27.7%). The quality and number of transferred embryos had the most significant impact on the pregnancy rate. The fertilization rate and frequency distribution of good-quality embryos were lower in the case of immotile spermatozoa, and pregnancies were only achieved when motile spermatozoa had been used. [source]

Assisted reproductive technologies and birth defects

CONGENITAL ANOMALIES, Issue 2 2005
Kohei Shiota
ABSTRACT In vitro fertilization (IVF) and other assisted reproductive technologies (ART) are effective treatments for infertility and are widely provided at infertility clinics. Although IVF and related ART procedures are generally considered safe, some studies have suggested an excess occurrence of major malformations, low birth-weight and other perinatal complications in babies conceived by ART. Further, it was recently reported that IVF and intracytoplasmic sperm injection (ICSI) are associated with imprinting disorders in the offspring such as Beckwith-Wiedemann syndrome and Angelman syndrome. Here we review the human and animal studies investigating the potential risks of ART, and discuss the need for further investigation. [source]

Fertility treatment in male cancer survivors

INTERNATIONAL JOURNAL OF ANDROLOGY, Issue 4 2007
Kirsten Louise Tryde Schmidt
Summary The present study reviews the use of assisted reproductive technology in male cancer survivors and their partners. As antineoplastic treatment with chemotherapy or radiation therapy, has the potential of inducing impairment of spermatogenesis through damage of the germinal epithelium, many male cancer survivors experience difficulties in impregnating their partners after treatment. The impairment can be temporary or permanent. While many cancer survivors regain spermatogenesis months to years after treatment, some become infertile with a-, oligo- or azoospermia. An option to secure the fertility potential of young cancer patients is to cryopreserve semen before cancer treatment for later use. A desired pregnancy may be obtained in couples where the husband has a history of cancer, using assisted reproductive technology with either fresh or cryopreserved/thawed semen. Successful outcomes have been obtained with intrauterine insemination (IUI) as well as in vitro fertilization (IVF) with or without the use of intracytoplasmic sperm injection (ICSI). In conclusion, male cancer survivors and their partners who have failed to obtain a pregnancy naturally within a reasonable time frame after end of treatment should be referred to a fertility clinic. [source]

Intracytoplasmic sperm injection as a complement to gonadotrophin treatment in infertile men with hypogonadotrophic hypogonadism

Comparison of the outcome of intracytoplasmic sperm injection in obstructive and non-obstructive azoospermia in the first cycle: a report of case series and meta-analysis

INTERNATIONAL JOURNAL OF ANDROLOGY, Issue 1 2005
MOHAMED GHANEM
Summary To investigate the outcome of intracytoplasmic sperm injection with fresh and cryopreserved-thawed testicular spermatozoa in the first cycle in patients with obstructive azoospermia (OA) and non-obstructive azoospermia (NOA), a total of 90 cases, 48 OA and 42 NOA were studied. All patients underwent sperm retrieval by testicular sperm extraction (TESE) while their wives received conventional ovarian hyperstimulation. The hormone levels, testicular histology, the rates of sperm retrieval, fertilization, implantation and pregnancy were analysed and evaluated. This study and other four similar studies were subjected to meta-analysis. Sperm retrieval was successful in 100% OA and 61% NOA. Fresh spermatozoa were used in 87.5% and 92.4% of OA and NOA cases respectively; while cryopreserved-thawed spermatozoa were used in 12.5% and 7.6% of OA and NOA, respectively. The fertilization, implantation and clinical pregnancy rates were 65.5%, 15% and 25% respectively in OA group, and 54.2%, 5% and 23.1% respectively in NOA group. Sperm status (fresh or thawed), male partner's age, female age and male serum follicle-stimulating hormone had no significant effect upon fertilization rate, implantation rate, or pregnancy rate per embryo transfer. The results of meta-analysis indicate that there is no statistically significant difference in clinical pregnancy rates between the two groups. There was a significantly higher fertilization rate among OA patients in all analysed studies (95% CI = 14.29,15.71, d.f. 832, T = 1.96). In conclusion, although the fertilization rate was significantly higher in the OA group in our study and from the given meta-analysis, there were some differences as regards pregnancy rates. Although the overall effect was more or less similar pregnancy rates in both subtypes of azoospermia, this may not be true if non-male infertility variables were controlled for in all studies. [source]

Penile vibratory stimulation and electroejaculation in the treatment of ejaculatory dysfunction,

INTERNATIONAL JOURNAL OF ANDROLOGY, Issue 6 2002
JENS SØNKSEN
Summary The purpose of this review is to present the current understanding of penile vibratory stimulation (PVS) and electroejaculation (EEJ) procedures and its clinical use in men with ejaculatory dysfunction. Unfortunately, the record of treating such individuals has been quite poor, but within recent years development and refinement of PVS and EEJ in men with spinal cord injury (SCI) has significantly enhanced the prospects for treatment of ejaculatory dysfunction. The majority of spinal cord injured men are not able to produce antegrade ejaculation by masturbation or sexual stimulation. However, approximately 80% of all spinal cord injured men with an intact ejaculatory reflex arc (above T10) can obtain antegrade ejaculation with PVS. Electroejaculation may be successful in obtaining ejaculate from men with all types of SCI, including men who do not have major components of the ejaculatory reflex arc. Because vibratory stimulation is very simple in use, non-invasive, it does not require anaesthesia and is preferred by the patients when compared with EEJ, PVS is recommended to be the first choice of treatment in spinal cord injured men. Furthermore, EEJ has been successfully used to induce ejaculation in men with multiple sclerosis and diabetic neuropathy. Any other conditions which affect the ejaculatory mechanism of the central and/or peripheral nervous system including surgical nerve injury may be treated successfully with EEJ. Finally, for sperm retrieval and sperm cryopreservation before intensive anticancer therapy in pubertal boys, PVS and EEJ have been successfully performed in patients who failed to obtain ejaculation by masturbation. Nearly all data concerning semen characteristics in men with ejaculatory dysfuntion originate from spinal cord injured men. Semen analyses demonstrate low sperm motility rates in the majority of spinal cord injured men. The data give evidence of a decline in spermatogenesis and motility of ejaculated spermatozoa shortly after (few weeks) an acute SCI. Furthermore, it is suggested that some factors in the seminal plasma and/or disordered storage of spermatozoa in the seminal vesicles are mainly responsible for the impaired semen profiles in men with chronic SCI. Home insemination with semen obtained by penile vibratory and introduced intravaginally in order to achieve successful pregnancies may be an option for some spinal cord injured men and their partners. The majority of men will further enhance their fertility potential when using either penile vibratory or EEJ combined with assisted reproduction techniques such as intrauterine insemination or in-vitro fertilization with or without intracytoplasmic sperm injection. [source]

Microdissection testicular sperm extraction: Prediction, outcome, and complications

INTERNATIONAL JOURNAL OF UROLOGY, Issue 10 2007
Akira Tsujimura
Abstract: Testicular spermatozoa can be retrieved successfully by the testicular sperm extraction (TESE) procedure and used for intracytoplasmic sperm injection in cases of non-obstructive azoospermia (NOA). The successful application of TESE depends on the identification of seminiferous tubules containing spermatozoa; testicular tubules of patients with NOA are usually heterogeneous, and TESE may not always be successful in these patients. Microdissection TESE with an operative microscope is advantageous because larger, more opaque, and whitish tubules, presumably containing germ cells with active spermatogenesis, can be identified directly. This procedure is currently the best method for the certain identification of sperm, resulting in a high spermatozoa retrieval rate and minimal postoperative complications. The present review considers the surgical procedure, outcome, prediction for spermatozoa retrieval, and postoperative complications of microdissection TESE. [source]

Diagnosis and treatment of post-herniorrhaphy vas deferens obstruction

INTERNATIONAL JOURNAL OF UROLOGY, Issue 2000
Tadashi Matsuda
Childhood inguinal herniorrhaphy (IH) is one of the most frequent causes of seminal tract obstruction. The incidence of vasal obstruction was found to be as high as 26.7% in subfertile patients with a history of childhood IH. The distal end of the vas deferens was found at the internal inguinal ring or in the pelvic cavity in 56.7% of cases, more than 3 cm of the vas deferens had been resected in 37.9% of cases, and sperm was found in vasal fluid in 45.5% of cases during corrective surgery. Microsurgical two-layer vasovasostomy resulted in the postoperative appearance of sperm in 39% of patients. In patients with postoperative azoospermia, a secondary epididymal obstruction caused by a long-term vasal obstruction is a highly probable cause. Ipsilateral epididymovasostomy following successful inguinal vasovasostomy results in the postoperative appearance of sperm in the ejaculate in 100% of the patients and a subsequent natural pregnancy rate of 50%. The overall pregnancy rate among couples, following surgery in 18 patients, was 43%, excluding pregnancies achieved by in vitro fertilization or intracytoplasmic sperm injection. Microsurgical reanastomosis of the seminal tract resulted in high impregnation rates among partners of patients with seminal tract obstruction caused by childhood IH. After receiving sufficient information on each treatment modality, patients can choose their preferred treatment, either reanastomosis of the seminal tract or assisted reproductive technology using epididymal or testicular sperm. [source]

Bayesian statistics in medical research: an intuitive alternative to conventional data analysis

JOURNAL OF EVALUATION IN CLINICAL PRACTICE, Issue 2 2000
AStat, Lyle C. Gurrin BSc (Hons)
Summary Statistical analysis of both experimental and observational data is central to medical research. Unfortunately, the process of conventional statistical analysis is poorly understood by many medical scientists. This is due, in part, to the counter-intuitive nature of the basic tools of traditional (frequency-based) statistical inference. For example, the proper definition of a conventional 95% confidence interval is quite confusing. It is based upon the imaginary results of a series of hypothetical repetitions of the data generation process and subsequent analysis. Not surprisingly, this formal definition is often ignored and a 95% confidence interval is widely taken to represent a range of values that is associated with a 95% probability of containing the true value of the parameter being estimated. Working within the traditional framework of frequency-based statistics, this interpretation is fundamentally incorrect. It is perfectly valid, however, if one works within the framework of Bayesian statistics and assumes a ,prior distribution' that is uniform on the scale of the main outcome variable. This reflects a limited equivalence between conventional and Bayesian statistics that can be used to facilitate a simple Bayesian interpretation based on the results of a standard analysis. Such inferences provide direct and understandable answers to many important types of question in medical research. For example, they can be used to assist decision making based upon studies with unavoidably low statistical power, where non-significant results are all too often, and wrongly, interpreted as implying ,no effect'. They can also be used to overcome the confusion that can result when statistically significant effects are too small to be clinically relevant. This paper describes the theoretical basis of the Bayesian-based approach and illustrates its application with a practical example that investigates the prevalence of major cardiac defects in a cohort of children born using the assisted reproduction technique known as ICSI (intracytoplasmic sperm injection). [source]

Stimulation day-six serum estradiol: A predictive indicator for the probability of embryo cryopreservation in IVF/ICSI cycles

JOURNAL OF OBSTETRICS AND GYNAECOLOGY RESEARCH (ELECTRONIC), Issue 2 2009
Hassan A. El Maghraby
Abstract Objective:, To evaluate the predictive value of stimulation day six serum estradiol (E2) for the probability of embryo cryopreservation after fresh embryo transfer in intracytoplasmic sperm injection (ICSI) cycles. Subjects and Methods:, The study included 282 ICSI cycles for different causes of infertility, provided that the age of the female partner was <40 years and her basal follicle stimulating hormone <10 IU/L. Setting:, Alexandria IVF/ICSI center. Main Outcome Measures:, Primary outcome measures are stimulation day-six serum E2, and rate of embryo cryopreservation, after transfer of three good-quality embryos. Secondary outcome measures are pregnancy rate per fresh embryo transfer, and other intermediate variables of the ICSI cycle. Results:, Patients were stratified into three groups according to day-six serum E2 levels: Group I with values <400 pg/mL; Group II, between 400 and 900; and Group III with values >900. The mean number of oocytes retrieved was 6.3, 8.9, and 12.4; the mean number of obtained embryos was 3.3, 4.8, and 6.7; and pregnancy rates were 18.1, 36.2, and 44.7% in the three groups, respectively. Rate of embryo cryopreservation, after transfer of three good-quality embryos was 70.7% in Group III, and 26.5% in Group I. (P = 0.01). The negative predictive value of day-six E2 < 400 pg/mL for freezing was 83% while day-six serum E2 > 900 pg/mL has a sensitivity of 55%, specificity of 72% and positive predictive value of 50% for embryo freezing. Conclusion:, Higher stimulation day-six estradiol was associated with a higher probability of cryopreservation, and a higher pregnancy rate. [source]

Middle Eastern Masculinities in the Age of New Reproductive Technologies: Male Infertility and Stigma in Egypt and Lebanon

MEDICAL ANTHROPOLOGY QUARTERLY, Issue 2 2004
MARCIA C. INHORNArticle first published online: 8 JAN 200
Worldwide, male infertility contributes to more than half of all cases of childlessness; yet, it is a reproductive health problem that is poorly studied and understood. This article examines the problem of male infertility in two Middle Eastern locales, Cairo, Egypt, and Beirut, Lebanon, where men may be at increased risk of male infertility because of environmental and behavioral factors. It is argued that male infertility may be particularly problematic for Middle Eastern men in their pronatalist societies; there, both virility and fertility are typically tied to manhood. Thus, male infertility is a potentially emasculating condition, surrounded by secrecy and stigma. Furthermore, the new reproductive technology called intracytoplasmic sperm injection (ICSI), designed specifically to overcome male infertility, may paradoxically create additional layers of stigma and secrecy, due to the complex moral and marital dilemmas associated with Islamic restrictions on third-party donation of gametes. [male infertility, masculinity, new reproductive technologies, stigma, Egypt, Lebanon] [source]

Activation regimens for full-term development of rabbit oocytes injected with round spermatids

MOLECULAR REPRODUCTION & DEVELOPMENT, Issue 6 2009
Masumi Hirabayashi
The present study was designed to investigate the effect of activation regimens on full-term development of rabbit oocytes after round spermatid injection (ROSI). In the first series, rabbit oocytes were treated with 5 µM ionomycin before ROSI, after ROSI, or before and after ROSI. In addition, non-treated oocytes were subjected to intracytoplasmic sperm injection (ICSI) using ejaculated spermatozoa. Cleavage rate of ROSI oocytes activated before and after ROSI (55%) was comparable with that of ICSI oocytes (60%), and significantly higher than those of ROSI oocytes activated either before or after ROSI (29,39%; P,<,0.05). No offspring were produced by transfer of the cleaving ROSI oocytes, while 8% of the cleaving ICSI oocytes transferred gave birth to offspring. In the second series, oocytes were exposed to 5, 10, or 20 µM ionomycin, followed by ROSI, 5 µM ionomycin treatment, and incubation with 5 µg/ml cycloheximide (CHX),+,2 mM 6-dimethylaminopurine (DMAP). Significantly higher cleavage rates were derived from oocytes activated with 10 and 20 µM ionomycin before ROSI (91% and 82%, respectively; P,<,0.05) compared to those activated with 5 µM ionomycin before ROSI (53%). Live offspring were obtained when the cleaving ROSI oocytes with the initial ionomycin treatment at 5 and 10 µM were transferred (offspring rate 2% and 4%, respectively). These activation regimens, however, were not valid for the ROSI using cryopreserved round spermatids. In conclusion, rabbit ROSI oocytes were capable of developing into full-term when the oocytes were activated with a combined treatment of ionomycin and CHX/DMAP. Mol. Reprod. Dev. 76: 573,579, 2009. © 2008 Wiley-Liss, Inc. [source]

Functional assessment of centrosomes of spermatozoa and spermatids microinjected into rabbit oocytes,

MOLECULAR REPRODUCTION & DEVELOPMENT, Issue 3 2009
Masahito Tachibana
Abstract Although intracytoplasmic sperm injection (ICSI) is a widely used assisted reproductive technique, the fertilization rates and pregnancy rates of immature spermatids especially in round spermatid injection (ROSI) remain very low. During mammalian fertilization, the sperm typically introduces its own centrosome which then acts as a microtubule organizing center (MTOC) and is essential for the male and female genome union. In order to evaluate the function of immature germ cell centrosomes, we used the rabbit gamete model because rabbit fertilization follows paternal pattern of centrosome inheritance. First, rabbit spermatids and spermatozoa were injected into oocytes using a piezo-micromanipulator. Next, the centrosomal function to form a sperm aster was determined. Furthermore, two functional centrosome proteins (,-tubulin and centrin) of the rabbit spermatogenic cells were examined. Our results show that the oocyte activation rates by spermatozoa, elongated spermatids, and round spermatids were 86% (30/35), 30% (11/36), and 5% (1/22), respectively. Sperm aster formation rates after spermatozoa, elongated spermatids, and round spermatids injections were 47% (14/30), 27% (3/11), and 0% (0/1), respectively. The aster formation rate of the injected elongating/elongated spermatids was significantly lower than that of the mature spermatozoa (P,=,0.0242). Moreover, sperm asters were not observed in round spermatid injection even after artificial activation. These data suggest that poor centrosomal function, as measured by diminished aster formation rates, is related to the poor fertilization rates when immature spermatogenic cells are injected. Mol. Reprod. Dev. 76: 270,277, 2009. © 2008 Wiley-Liss, Inc. [source]

Effect of maturation stage at cryopreservation on post-thaw cytoskeleton quality and fertilizability of equine oocytes

MOLECULAR REPRODUCTION & DEVELOPMENT, Issue 5 2006
T. Tharasanit
Abstract Oocyte cryopreservation is a potentially valuable technique for salvaging the germ-line when a valuable mare dies, but facilities for in vitro embryo production or oocyte transfer are not immediately available. This study examined the influence of maturation stage and freezing technique on the cryopreservability of equine oocytes. Cumulus oocyte complexes were frozen at the immature stage (GV) or after maturation in vitro for 30 hr (MII), using either conventional slow freezing (CF) or open pulled straw vitrification (OPS); cryoprotectant-exposed and untreated nonfrozen oocytes served as controls. After thawing, GV oocytes were matured in vitro, and MII oocytes were incubated for 0 or 6 hr, before staining to examine meiotic spindle quality by confocal microscopy. To assess fertilizability, CF MII oocytes were subjected to intracytoplasmic sperm injection (ICSI) and cultured in vitro. At 12, 24, and 48 hr after ICSI, injected oocytes were fixed to examine their progression through fertilization. Both maturation stage and freezing technique affected oocyte survival. The meiosis resumption rate was higher for OPS than CF for GV oocytes (28% vs. 1.2%; P,<,0.05), but still much lower than for controls (66%). Cryopreserving oocytes at either stage induced meiotic spindle disruption (37%,67% normal spindles vs. 99% in controls; P,<,0.05). Among frozen oocytes, however, spindle quality was best for oocytes frozen by CF at the MII stage and incubated for 6 hr post-thaw (67% normal); since this combination of cryopreservation/IVM yielded the highest proportion of oocytes reaching MII with a normal spindle (35% compared to <20% for other groups), it was used when examining the effects of cryopreservation on fertilizability. In this respect, the rate of normal fertilization for CF MII oocytes after ICSI was much lower than for controls (total oocyte activation rate, 26% vs. 56%; cleavage rate at 48 hr, 8% vs. 42%: P,<,0.05). Thus, although IVM followed by CF yields a respectable percentage of normal-looking MII oocytes (35%), their ability to support fertilization is severely compromised. Mol. Reprod. Dev. © 2006 Wiley-Liss, Inc. [source]

Influence of oocyte collection technique on initial chromatin configuration, meiotic competence, and male pronucleus formation after intracytoplasmic sperm injection (ICSI) of equine oocytes,

MOLECULAR REPRODUCTION & DEVELOPMENT, Issue 1 2001
Maria Elena Dell'Aquila
Abstract There is a great variability in the success of horse oocyte maturation and fertilization among laboratories. This study was conducted to determine if the meiotic and developmental competence of horse oocytes could be dependent on the method of oocyte collection, i.e., aspiration of follicular fluid with a vacuum apparatus, or opening follicles and scraping the granulosa layer. Horse oocytes were recovered from abattoir ovaries by aspiration or scraping and classified as having compact (Cp), expanded (Ex), or partial (P) cumuli. In Experiment 1 (Part A in May and Part B in October), oocytes were fixed immediately after collection to assess whether the collection method influenced the initial chromatin configuration of oocytes. In Experiment 2, in vitro maturation rates of oocytes recovered by aspiration or scraping were compared. In Experiment 3, oocytes were matured in vitro and submitted to intracytoplasmic sperm injection (ICSI). Initial chromatin configuration differed according to collection method in that there was a significantly higher prevalence of diffuse chromatin within the germinal vesicle in oocytes recovered by scraping than in oocytes recovered by aspiration (29/87, 33% and 28/166, 17%, respectively; P,<,0.01). Maturation of oocytes to metaphase II did not significantly differ between scraped and aspirated oocytes (56/101, 55.4 % vs. 65/106, 61.4%, respectively). The overall pronucleus formation rate after ICSI of oocytes recovered by scraping was not significantly different than that of oocytes recovered by aspiration (50/99, 52.6% vs. 50/85, 68.5 %, respectively); however, the rate of abnormal fertilization was significantly higher for oocytes collected by aspiration (14/73, 19% vs. 6/94, 6%, respectively; P,<0.05). These results demonstrate that the collection method affects the population of recovered oocytes and may contribute to differences in results observed among laboratories working with horse oocytes. Mol. Reprod. Dev. 60: 79,88, 2001. © 2001 Wiley-Liss, Inc. [source]

Infertility, infertility treatment and psychomotor development: the Danish National Birth Cohort

PAEDIATRIC & PERINATAL EPIDEMIOLOGY, Issue 2 2009
Jin Liang Zhu
Summary Babies born of infertile couples, regardless of treatment, have a higher risk of preterm birth and low birthweight, conditions associated with delayed development. We examined developmental milestones in singletons as a function of parental infertility [time to pregnancy (TTP) > 12 months] and infertility treatment. From the Danish National Birth Cohort (1997,2003), we identified 37 897 singletons born of fertile couples (TTP , 12 months), 4351 born of infertile couples conceiving naturally (TTP > 12 months), and 3309 born after infertility treatment. When the children were about 18 months old, mothers reported 12 developmental milestones by responding to structured questions. We defined a failure to achieve the assessed milestone or the minimal numbers of milestones in a summary (motor, or cognitive/language skills) as delay. Naturally conceived children born of infertile couples had a pattern of psychomotor development similar to that of children born of fertile couples, but increasing TTP correlated with a modest delay. When the analysis was restricted to infertile couples (treated and untreated), children born after treatment showed a slight delay in cognitive/language development (odds ratio 1.24, [95% confidence interval 1.01, 1.53]) for not meeting at least three out of six cognitive/language milestones); children born after intracytoplasmic sperm injection (ICSI) had the highest estimated relative risk of delay for most milestones, especially motor milestones. These results suggest that a long TTP may be associated with a modest developmental delay. Infertility treatment, especially ICSI, may be associated with a slight delay for some of these early milestones. [source]

First-trimester serum marker distribution in singleton pregnancies conceived with assisted reproduction

PRENATAL DIAGNOSIS, Issue 4 2010
M. A. J. Engels
Abstract Objective To evaluate marker distribution of free ,-human chorionic gonadotrophin (f,-hCG) and pregnancy-associated plasma protein-A (PAPP-A) in singleton pregnancies conceived by assisted reproduction techniques (ART). Methods In vitro fertilization (IVF) (n = 203) and intracytoplasmic sperm injection (ICSI) (n = 192) cases from a database of 14 645 first-trimester combined tests (overall study group) were selected and matched to 1164 controls for gestational age at sample date and maternal age. Results In the IVF group and ICSI group, lnPAPP-A was lower (IVF 6.74 vs 7.08; P = 0.0001; ICSI 6.59 vs 7.07; P = 0.0001) compared with the matched controls. Lnf,-hCG was lower in the IVF group (3.75 vs 3.90; P = 0.005) but not significantly different in the ICSI group (3.87 vs 3.93; P = 0.27). The computed correction factors for PAPP-A and f,-hCG were 1.42 and 1.17 for the IVF group and 1.56 and 1.05 for the ICSI group. The false-positive rate (FPR) in the IVF and ICSI group compared with the matched controls was higher (IVF 10.3% vs 8.6% and ICSI 10.9% vs 7.5%). In the overall age-biased [maternal age significantly lower compared with all ART and control groups] study group the FPR was 6.8%. Conclusion The increase in FPR in the ART groups can be explained by decreased PAPP-A values. Therefore, an adjustment in risk analysis for Down syndrome is suggested. Copyright © 2010 John Wiley & Sons, Ltd. [source]

Full-Term Development of Rabbit Embryos Produced by ICSI with Sperm Frozen in Liquid Nitrogen without Cryoprotectants

REPRODUCTION IN DOMESTIC ANIMALS, Issue 4 2010
QY Li
Content The aim of the present study was to establish the technology of intracytoplasmic sperm injection (ICSI) in rabbit by using the sperm frozen without cryoprotectants. Observation under an electron microscope revealed that the rabbit spermatozoa frozen without cryoprotectants had severe damage especially in the plasma membrane and junction between head and tail. However, after being injected into the oocytes, the sperm frozen without cryoprotectants retained the capability of supporting the cleavage and development of the ICSI oocytes, with no significant difference from that of fresh sperm, although the development of ICSI embryos derived from either frozen sperm or fresh sperm is much lower than that of in vivo -fertilized zygotes. When additional artificial activation was applied following ICSI, the rates of cleavage and blastocyst formation of ICSI oocytes were significantly increased when compared with the oocytes without additional activation. Yet, the cell numbers in blastocysts were not significantly different between the activation and non-activation group. After embryo transfer, four offspring were obtained from the oocytes microinjected with the sperm frozen without cryoprotectants. The technology established by this study may facilitate exploring the ICSI-based transgenic method in rabbit and broaden the application of ICSI technique in related field. [source]

In Vitro Production of Equine Embryos: State of the Art

REPRODUCTION IN DOMESTIC ANIMALS, Issue 2010
K Hinrichs
Contents In vitro embryo production is possible in the horse both clinically and for research applications. Oocytes may be collected from excised ovaries post-mortem, or from either immature follicles or stimulated pre-ovulatory follicles in the live mare. In vitro maturation of immature oocytes typically yields approximately 60% mature oocytes. As standard in vitro fertilization is not yet repeatable in the horse, fertilization is performed by intracytoplasmic sperm injection. Embryo culture requires medium with high glucose, at least during blastocyst development, and rates of blastocyst development similar to those for cattle (25% to 35%) may be obtained. Pregnancy rates after transfer of in vitro -produced blastocysts are similar to those for embryos recovered ex vivo. [source]

Robust computer-controlled system for intracytoplasmic sperm injection and subsequent cell electro-activation

Practitioner Review: Outcomes for parents and children following non-traditional conception: what do clinicians need to know?

THE JOURNAL OF CHILD PSYCHOLOGY AND PSYCHIATRY AND ALLIED DISCIPLINES, Issue 3 2003
Susan Golombok
Background: The birth of the first ,test-tube' baby in 1978 has led to the creation of family types that would not otherwise have existed. Methods: This paper examines research on the psychological outcomes for parents and children in assisted reproduction families with particular attention to the issues and concerns that have been raised by creating families in this way. Results: Parents of children conceived by assisted reproduction appear to have good relationships with their children, even in families where one parent lacks a genetic link with the child. With respect to the children themselves, there is no evidence of cognitive impairment in singleton children born at full term as a result of assisted reproduction procedures, although the findings regarding the cognitive development of intracytoplasmic sperm injection (ICSI) children are currently unclear. In relation to socioemotional development, assisted reproduction children appear to be functioning well. Conclusions: Few studies have included children at adolescence or beyond, and little is known about the consequences of conception by assisted reproduction from the perspective of the individuals concerned. In addition, there are some types of assisted reproduction family, such as families created through a surrogacy arrangement or through embryo donation, about whom little is known at all. Although existing knowledge about the impact of assisted reproduction for parenting and child development does not give undue cause for concern, there remain a number of unanswered questions in relation to children born in this way. [source]

Modalities for Treatment of Antisperm Antibody Mediated Infertility: Novel Perspectives

AMERICAN JOURNAL OF REPRODUCTIVE IMMUNOLOGY, Issue 5 2004
Rajesh K. Naz
Immunoinfertility because of antisperm antibodies (ASA) is an important cause of infertility in humans. The incidence of ASA in infertile couples is 9,36% depending on the reporting center. Early claims regarding the incidence and involvement of ASA in involuntary infertility were probably overemphasized, which has resulted in subsequent confusion, doubt, and underestimation of their clinical significance. No immunoglobulin that binds to sperm should be called an antisperm antibody in a strict sense unless it is directed against a sperm antigen that plays a role in fertilization and fertility. ASA directed against the fertilization-related antigens are more relevant to infertility than the immunoglobulins that bind to sperm associated antigens. Several methods have been reported for treatment of immunoinfertility. These include: immunosuppressive therapies using corticosteroids or cyclosporine; assisted reproductive technologies such as intrauterine insemination, gamete intrafallopian transfer, in vitro fertilization, and intracytoplasmic sperm injection; laboratory techniques such as sperm washing, immunomagnetic sperm separation, proteolytic enzyme treatment, and use of immunobeads. Most of the available techniques have side effects, are invasive and expensive, have low efficacy, or provide conflicting results. Recent findings using defined sperm antigens that have a role in fertilization/fertility have provided animal models and innovative novel perspectives for studying the mechanism of immunoinfertility and possible modalities for treatment. The better understanding of local immunity and latest advances in hybridoma and recombinant technologies, proteomics and genomics leading to characterization of sperm antigens relevant to fertility will help to clarify the controversy and to establish the significance of ASA in infertility. [source]

Fibroblast Growth Factor (FGF), Intracellular Adhesion Molecule (sICAM-1) Level in Serum and Follicular Fluid of Infertile Women with Polycystic Ovarian Syndrome, Endometriosis and Tubal Damage, and their Effect on ICSI Outcome

AMERICAN JOURNAL OF REPRODUCTIVE IMMUNOLOGY, Issue 2 2003
M. E. Hammadeh
PROBLEM: The objective of this study was to determine the concentration of fibroblast growth factor (FGF) and soluble intracellular adhesions molecule (sICAM-1) in serum and follicular fluid (FF) of polycystic ovary (PCO), endometriosis and tubal factor infertility and male factor infertility patients, and to investigate the relationship between these parameters and the outcome of intracytoplasmic sperm injection (ICSI). METHOD OF STUDY: The concentration of FGF and sICAM-1 in serum and FF were determined in patients undergoing controlled ovarian hyperstimulation (COH) for ICSI therapy for various etiology of infertility and the results of cytokines concentration and ICSI outcome were compared between the groups. Twenty patients with PCO (G.I), 17 with endometriosis (G.II), 19 with tubal damage (G.III) and 19 with male factor infertility (G.IV) were enrolled in this study. Quantitative determination of levels of FGF and sICAM-1 was performed using enzyme-linked immunosorbent assays (ELISAs). RESULTS: The FGF level in serum of PCO patients (G.I) were 4.8 ± 2.3 and in FF were 104.0 ± 39.0 pg/mL. The corresponding values in the endometriosis patients group (G.II) were 5.9 ± 3.1 and 125.4 ± 74.9 pg/mL. The concentration of FGF in tubal factor infertility group (G.III) in serum was significantly higher (P = 0.009) than those observed in the PCO group (G.I) 7.4 ± 4.5 pg/mL, whereas the concentration in FF was at the same level like the other groups investigated, 128.7 ± 75.9 pg/mL. Besides, the sICAM-1 (pg/ml) concentration in FF showed a significant difference between the groups investigated (G.I, 175.3 ± 52.8; G.II 194.4 ± 32.2; G.III 233.1 ± 54.3; and G.IV 215.1 ± 54.4 ng/mL; P = 0.003). The sICAM-1 levels in serum were not significantly different between the groups (217.0 ± 42.9; 216.3 ± 73.6; 254.8 ± 79.6; 237.56 ± 78.4 ng/ml; P = 0.267). The fertilization rate was significantly higher in G.III (66.0 ± 23.89%) in comparison to G.II (38.8 ± 33.9%; P = 0.014) or G.IV (38.7 ± 22.7%; P = 0.012). The pregnancy rates were similar in all groups (30, 35.3 and 35.0, 38.6%, respectively). CONCLUSION: Both, FGF and sICAM-1 are present in serum and FF of patients undergoing controlled ovarian hyperstimulation for ICSI therapy. The FGF concentration in serum differs significantly between the groups investigated, whereas, no significant difference could be observed in the FF concentration of FGF. On the other hand, the sICAM in serum showed no significant difference between the groups, whereas, sICAM in FF demonstrated a significant difference between the patient groups investigated. On the whole, the ICSI outcome was not related to serum or FF concentrations of FGF or sICAM-1. Therefore, the mean concentration of FGF and sICAM-1 in serum and in FF could not be used to predict the fertilization rate in an ICSI program. [source]

Can a cumulus cell complex be used to select spermatozoa for assisted reproduction?

ANDROLOGIA, Issue 6 2009
D. R. Franken
Summary Since the onset of intracytoplasmic sperm injection, researchers have intensified the search for the ideal spermatozoa to be used for injection. The aim of this study was to record the functional role of cumulus cell interaction with human spermatozoa as far as capacitation, acrosome reaction, morphology, zona binding and chromatin packaging quality are concerned. Using a previously described cumulus oophorus model, we recorded specific sperm functional aspects of sperm populations that transverse a cumulus cells mass. Control spermatozoa were kept under similar experimental conditions in the culture media only. Results indicated cumulus cells to be beneficial to spermatozoa as far as functional and capacitational events are concerned. The mean percentage of morphologically normal spermatozoa in the control sample was 6.9%, while the spermatozoa that traversed the cumulus oophorus (test) had a significantly higher percentage of normal forms (mean 9.5%; P , 0.01). We observed a decline in the percentage of CMA3-positive spermatozoa when we compared the control population (49.1%) to the test, i.e. 38.4%, (P = <0.05), thus implying that the spermatozoa with good chromatin condensation increased during cumulus penetration. Significantly more (P , 0.01) acrosome-reacted spermatozoa were found in the penetrated spermatozoa (mean 23%) than in the control spermatozoa (mean 11%). The test spermatozoa had a higher zona binding capacity with significantly more (P , 0.01) tightly bound spermatozoa on the hemizona (61 ± 15) than the control spermatozoa (47 ± 18). In the absence of sophisticated and expensive sperm selection products, the use of a cumulus model to select spermatozoa for intracellular sperm injection seems to be an alternative method. [source]

Fertilisation and pregnancy outcome after ICSI in globozoospermic patients without assisted oocyte activation

ANDROLOGIA, Issue 1 2009
S. Bechoua
Summary The successful outcome of intracytoplasmic sperm injection (ICSI) with globozoospermic sperm and non-activated oocytes is reported. Three couples underwent ICSI treatment and two of the patients were siblings. Forty-four non-activated oocytes were injected, 26 oocytes fertilised normally and 17 good quality embryos were obtained. Six embryo transfers were carried out, three with fresh embryos and three with frozen-thawed embryos. Three pregnancies resulted from the fresh embryo transfers and additionally two pregnancies were obtained after the transfer of frozen-thawed embryos. Two healthy babies were born. One twin pregnancy is ongoing. Our case reports demonstrate that in some ICSI attempts undertaken with globozoospermic sperm cells from two of our patients, high fertilisation rates, pregnancies and live births can be achieved, without artificially activated oocytes. Our data also suggest that in some cases, round-headed spermatozoa lack the capacity to activate the oocyte. Therefore, it cannot be excluded that artificial oocyte activation could be of help in globozoospermic patients with complete fertilisation failure. [source]

Primary male infertility in Kuwait: a cytogenetic and molecular study of 289 infertile Kuwaiti patients

ANDROLOGIA, Issue 3 2007
F. Mohammed
Summary Infertility is one of the major public health problems, affecting 15% of couples who attempt pregnancy; in 50% of these, the male partner is responsible. Chromosomal abnormalities and Y microdeletions in the azoospermia factor (AZF) region are known to be associated with spermatogenetic failure. In the present study, 289 patients with primary male infertility because of spermatogenetic failure were studied in order to highlight the molecular background of male infertility in Kuwait, and to avoid the possibility of transmission of any microdeletions/chromosomal aberrations to offspring via intracytoplasmic sperm injection (ICSI). Of the 289 infertile men, 23 patients (8%) had chromosomal aberration in the form of Klinefelter syndrome/variant (16/23; 69.6%), XYY syndrome (3/23; 13%), XX male syndrome (2/23; 8.7%), 45,X/46X, i(Yp)(1/23; 4.4%) and 45,XY, t(9;22) (1/23;4.4%). Y-chromosome microdeletion in the AZFb and AZFc regions were detected in 7/266 cases (2.6%). Testicular biopsy was carried out in 31 azoospermic patients, of whom five men had Sertoli-cell only syndrome, while 26 patients had spermatogenic arrest. In conclusion, this study showed that the frequency of both chromosomal anomalies and Y microdeletions were found in 10.4% of the infertile men. The potential risk of transmitting these genetic disorders to offspring provides a rationale for screening infertile men prior to ICSI. [source]

Influence of motility and vitality in intracytoplasmic sperm injection with ejaculated and testicular sperm

ANDROLOGIA, Issue 4 2005
T. Stalf
Summary The vitality of spermatozoa used for intracytoplasmic sperm injection (ICSI) is a crucial factor for fertilization, establishment and outcome of a pregnancy in assisted reproductive technique cycles. The sperm origin may also be a limiting factor, although little is known about this issue. It is known that the motility of injected spermatozoa and their origin from ejaculate or testicular biopsies are important predictors in terms of fertilization, pregnancy and birth rates. Oocytes of patients in 2593 cycles were retrieved in our in vitro fertilization programme and inseminated via ICSI. We used motile (group 1, n = 2317) or immotile ejaculated spermatozoa (group 2, n = 79), motile sperm retrieved from testicular biopsies (group 3, n = 62) and immotile spermatozoa from testicular biopsies (group 4, n = 135). Female age and number of oocytes retrieved did not differ significantly among the groups. The fertilization rates were as follows: 67.1% in group 1, 49.8% in group 2, 68.3% in group 3 and 47.8% in group 4. The pregnancy rates in cases where three embryos had been transferred amounted to 35.7% in group 1, 17.3% in group 2, 38.3% in group 3 and 20.5% in group 4. The embryo quality showed no differences between groups 1 and 3 (14.5), and between groups 2 (11.8) and 4 (10.8). The abortion rate was similar in groups 1,3, but increased in group 4 (26.6%, 27.3%, 31.6% and 55.5%). Irrespective of their origin, the fertilization potential of injected spermatozoa was found to be influenced by motility. The resulting pregnancy and birth rates, i.e. the potential of the resulting embryos to implant and to achieve viable pregnancies, seem to be additionally dependent on the sperm origin. This was well shown by declining rates when spermatozoa in a relatively early stage of maturity had been used. We see increasing evidence that the degree of sperm maturity has an important impact on the outcome of ICSI. In obstructive azoospermia, spermatozoa retrieved from the epididymis should be used rather than testicular biopsy spermatozoa, or testicular sperm should be preincubated in culture medium before ICSI. [source]