Clinical and Experimental Reproductive Medicine

The Korean Society for Reproductive Medicine (대한생식의학회)
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Semen parameters on the intracytoplasmic sperm injection day: Predictive values and cutoff thresholds of success

  • Moubasher, Alaa El din-Abdel Aal (Department of Dermatology, Venereology and Andrology, Faculty of Medicine, Assiut University) ;
  • Taha, Emad Abdelrehim (Department of Dermatology, Venereology and Andrology, Faculty of Medicine, Assiut University) ;
  • Elnashar, Ehab Mohamed (Department of Obstetrics and Gynecology, Faculty of Medicine, Assiut University) ;
  • Maged, Ahmed Abdel Aal Abdel (Department of Dermatology, Venereology and Andrology, Faculty of Medicine, Assiut University) ;
  • Zahran, Asmaa Mohamed (Department of Clinical Pathology, South Egypt Cancer Institute, Assiut University) ;
  • Sayed, Heba Hassan (Department of Dermatology, Venereology and Andrology, Faculty of Medicine, Assiut University) ;
  • Gaber, Hisham Diab (Department of Dermatology, Venereology and Andrology, Faculty of Medicine, Assiut University)
  • Received : 2020.07.30
  • Accepted : 2020.10.14
  • Published : 2021.03.31
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Abstract

Objective: This study was conducted to investigate the relationship of semen parameters in samples used for intracytoplasmic sperm injection (ICSI) with fertilization and pregnancy rates in infertile couples. Methods: In this prospective study of Infertile couples with male factor infertility that had undergone ICSI, fractions of the same semen samples obtained for microinjection (to ensure the best predictability) were evaluated to determine the semen parameters and sperm DNA fragmentation index (DFI) on the day of oocyte recovery. Results: In total, 120 couples completed the study and were subdivided into fertilized (n=87) and non-fertilized couples (n=33). The fertilized couples were further classified into pregnant (n=48) and non-pregnant (n=39) couples. Compared to non-fertilized and non-pregnant couples, fertilized and pregnant couples showed statistically significantly higher sperm viability and percentage of normal sperm morphology, as well as significantly lower sperm DFI values. A receiver operating characteristic curve analysis of data from the 120 ICSI cycles showed that sperm viability, normal sperm morphology percentages, and sperm DFI were significant prognostic indicators of fertilization at cutoff values of 40%, 7%, and 46%, respectively. A sperm DFI of 46% showed sensitivity and specificity of 95% and 90%, respectively, for predicting fertilization, and no clinical pregnancies occurred in couples with a sperm DFI above 46%. Conclusion: Semen parameters from the ICSI day sample, especially sperm viability, normal morphology, and DFI, had an impact on fertilization and pregnancy outcomes in ICSI cycles.

Keywords

Acknowledgement

We thank all patients participating in this investigation, as well as the medical and lab staff at the Faculty of Medicine, Assiut University, who helped us during this study.

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