The analysis of sperm morphology can be used to evaluate sperm fertilizing ability and spontaneous conception status, and especially the overall analysis of the sperm head, neck and tail, along with the patient's living habits, occupation and clinical manifestations, may contribute to the primary diagnosis of the patients potentia generandi. It can also be employed to assess the effects of the treatment of semen samples. Although oocyte fertilization can be achieved by the technologies of intracytoplasmic sperm injection (ICSI), motile sperm organelle morphology examination (MSOME) and intracytoplasmic morphologically selected sperm injection (IMSI) regardless of sperm morphology and / or motility, which may somewhat weaken the clinical application of sperm morphology analysis, the standardized procedure and the practice of quality control for the analysis of sperm morphology can significantly improve the accuracy of its results and largely promote its clinical application. Therefore, it is of positive necessity as well as clinical application value to perform sperm morphology analysis in andrology laboratories, reproductive centers, sperm banks and the department of laboratory medicine.
Humans ; Male ; Semen Analysis ; Sperm Injections, Intracytoplasmic ; methods ; Sperm Motility

OBJECTIVETo analyze the clinical outcomes of intracytoplasmic sperm injection (ICSI) with spermatozoa from different sources.

METHODSWe retrospectively studied the rates of fertilization, clinical pregnancy, implantation, abortion, ectopic pregnancy and delivery in 682 patients treated by ICSI, who were divided according to the sperm sources into an ejaculated sperm group (ES, n = 598), a percutaneous epididymal sperm aspiration (PESA, n = 58) and a testicular sperm extraction (TSE, n = 26).

RESULTSThe fertilization rate was significantly lower in the TSE than in the ES and PESA groups (81.06% vs 87.95% and 87.82%, P < 0.05). But no statistically significant differences were observed among the ES, PESA and TSE groups in the rates of clinical pregnancy (39.46%, 48.28% and 34.62%), implantation (19.80%, 23.80% and 18.34%), abortion (13.13%, 17.86% and 11.11%), ectopic pregnancy (5.51%, 7.14% and 11.11%) and delivery (32.11%, 36.21% and 26.92%) (P > 0.05).

CONCLUSIONAlthough TSE-obtained sperm affect the rate of fertilization, those obtained by TSE and PESA do not obviously influence the outcome of clinical pregnancy.

Adult ; Female ; Humans ; Male ; Pregnancy ; Pregnancy Outcome ; Retrospective Studies ; Sperm Injections, Intracytoplasmic ; methods ; Sperm Retrieval ; Spermatozoa

OBJECTIVETo explore the effects of fertilization methods and sperm sources in intracytoplasmic sperm injection (ICSI) on the developmental capacity of surplus embryos.

METHODSWe analyzed the blastocyst formation of the surplus embryos from 2 135 patients, who were divided according to fertilization methods into an IVF (n=1803) and an ICSI group (n=332), the former again allocated to a normal fertilization (n=1642) and a rescue fertilization group (n=161), and the latter, according to sperm sources, to an ejaculated (n=248), an epididymal (n=70) and a testicular sperm group (n=14). The rates of blastocyst formation and good-quality blastocysts were compared between different fertilization methods and sperm sources.

RESULTSA total of 1884 blastocysts (28.87%) formed from 6525 surplus embryos of the patients after sequential culture, of which 974 (51.70%) were good-quality ones. The blastocyst formation rate of surplus embryos was significantly higher in the IVF (30.14%) than in the ICSI group (21.40%, P < 0.05), the rate of good-quality blastocysts was also higher in the former (52.44%) than in the latter (45.54%), but with no significant difference (P > 0.05). The rates of blastocyst formation and good-quality blastocysts were significantly higher in the normal (31.04% and 53.28%) than in the rescue fertilization IVF group (20.38% and 38.54%, P < 0.05), and in the testicular sperm ICSI group (30.23% and 53.85%) than in either the epididymal (18.36% and 42.11%) or the ejaculated sperm ICSI group (21.76% and 45.70%) (P < 0.05).

CONCLUSIONThe development potential of surplus embryos was higher in IVF than in ICSI, in the normal than in the rescue fertilization IVF group, and in the testicular than in the epididymal and ejaculated sperm ICSI groups.

Blastocyst ; Embryonic Development ; Female ; Fertilization in Vitro ; methods ; Humans ; Male ; Oocytes ; Sperm Capacitation ; Sperm Injections, Intracytoplasmic ; methods ; Sperm Motility

OBJECTIVETo determine an optimal insemination technique for patients suspected of high risk of fertilization failure and undergoing assisted reproduction treatment.

METHODSNinety-nine couples were treated by conventional in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI) in one cycle (half-ICSI) by dividing the sibling oocytes in halves. The clinical and laboratory data were analyzed, and the rates of fertilization, cleavage, good embryos and clinical pregnancy were compared between different fertilization methods.

RESULTSIn the half-ICSI group, the fertilization rate of ICSI (80.5%) was significantly higher than that of IVF (42.9%) (P < 0.01), and so were the rates of complete fertilization failure (21.2%) and low fertilization (16.2%) of IVF than those of ICSI (0 and 3.0%). No significant differences were observed in the rates of cleavage and good-quality embryos between the two groups (P > 0.05).

CONCLUSIONICSI can help to avoid complete fertilization failure, achieve more high quality embryos for transfer and improve the rate of pregnancy for patients with high risk of fertilization failure.

Female ; Fertilization in Vitro ; methods ; Humans ; Male ; Oocytes ; cytology ; Pregnancy ; Pregnancy Outcome ; Sperm Injections, Intracytoplasmic ; methods

Total or near-total fertilization failure after intracytoplasmic sperm injection (ICSI) is a rare event, but it occurs repeatedly because of sperm defects in activating oocyte. The case presents a successful pregnancy and live birth after calcium ionophore A23187 (A23187) activation on one-day-old unfertilized oocytes in a patient whose husband suffered oligoasthenoteratozoospermia, and who had experienced repeated near-total fertilization failure after ICSI. In the second ICSI cycle, only one oocyte was fertilized while nine were unfertilized. Oocyte activation with A23187 were performed on the one-day-old unfertilized oocytes after ICSI and resulted in fertilization and embryo transfer. A clinical pregnancy was achieved and a healthy baby was born. To our knowledge, this is the first reported case of a healthy birth after oocyte activation on the one-day-old unfertilized oocyte. This indicates that "rescue oocyte activation" on one-day-old unfertilized oocytes after ICSI may be helpful for preventing total or near-total fertilization failure after ICSI.
Adult ; Female ; Fertilization in Vitro ; methods ; Humans ; Live Birth ; Male ; Oocytes ; cytology ; Pregnancy ; Sperm Injections, Intracytoplasmic ; methods

Sperm selection plays an important role in assisted reproductive technology. In recent years, sperm evaluation is not limited to the assessment of sperm motility and morphology, but involves more other sperm characteristics such as sperm ultrastructure, DNA integrity, apoptosis and membrane. Assessment based on these characteristics is becoming the aim of sperm selection. This article gives an overview on several newly developed techniques for sperm selection according to different technical principles, such as electrophoretic separation, zeta potential, HA binding, Annexin V binding, intracytoplasmic morphologically selected sperm injection (IMSI) and microfluidic sperm sorter, which have all been applied to IVF or ICSI with the exception of microfluidic sperm sorter. It also introduces the advantages, disadvantages and application effects of these techniques.
Cell Separation ; Fertilization in Vitro ; methods ; Humans ; Male ; Reproductive Techniques, Assisted ; Semen Analysis ; Sperm Injections, Intracytoplasmic ; methods

This paper describes the use of piezo-driven micropipette for intracytoplasmic sperm injection of mice eggs. The head of fresh spermatozoa from KM (Kunming) fertile mice was individually injected into mature oocytes of hybrid mice B6D2F1. Approximately eighty three percent of sperm-injected oocytes survived, and 84.0% of them fertilized normally (extrusion of the second polar body and formation of male and female pronuclei). The eggs fertilized by sperm injection could develop in vitro to 2-cell (98% vs 94.7%), 4-cell (89.5% vs 92.1%) stages, no significantly (P > 0.05) different from embryos fertilized in vivo but there were significantly (P < 0.01) few morulae (63.8% vs 84.2%) and blastocysts (25.7% vs 68.4%) developed in vitro after further culture in vitro in the group of ICSI. When 120 embryos at the pronuclear stage were transferred to seven pseudopregnant KM female, 23.3% of the embryos (0 - 50%, depending on the host) reached the full term. Except for three that were cannibalized soon after birth, all of the young (25 pups) developed into normal and fertile adult. Here we report the first birth of mouse offspring following ICSI in China. These studies may increase understanding of the fertilization process and of how ICSI works.
Animals ; Embryo Transfer ; Female ; Fertilization in Vitro ; methods ; Male ; Mice ; Oocytes ; physiology ; Pregnancy ; Sperm Injections, Intracytoplasmic ; methods

OBJECTIVETo compare the clinical outcomes of embryos selected using time-lapse microscopy and traditional morphological method in IVF/ICSI cycles and evaluate the clinical value of time-lapse microscopy in early embryo monitoring and selection.

METHODSe retrospectively analyzed the clinical data of 139 IVF/ICSI cycles with embryo selection based on time-lapse monitoring (TLM group, n=68) and traditional morphological method (control group, n=71). The βHCG-positive rate, clinical pregnancy rate and embryo implantation rate were compared between the 2 groups. Subgroup analysis was performed in view of female patients age and the fertilization type.

RESULTSThe βHCG-positive rate, clinical pregnancy rate and implantation rate were 66.2%, 61.8% and 47.1% in TLM group, significantly higher than those in the control group (47.9%, 43.7% and 30.3%, respectively; P<0.05). Compared with patients below 30 years of age, patients aged between 31 and 35 years benefited more from time-lapse monitoring with improved clinical outcomes. time-lapse monitoring significantly increased the βHCG-positive rate, clinical pregnancy rate and implantation rate for patients undergoing IVF cycles, but not for those undergoing ICSI or TESA cycles.

CONCLUSIONSCompared with those selected using traditional morphological method, the embryos selected with time-lapse microscopy have better clinical outcomes, especially in older patients (31-35 years of age) and in IVF cycles.

Embryo Implantation ; Embryo Transfer ; Female ; Humans ; Microscopy ; methods ; Pregnancy ; Pregnancy Rate ; Retrospective Studies ; Sperm Injections, Intracytoplasmic

Men with non-obstructive azoospermia(NOA) can now be treated by using intra-oocyte round spermatid injection(ROSI) or elongated spermatid injection(ELSI). Spermatids can be retrieved from semen or from testis biopsy specimens. But the rates of fertilization and pregnancy with spermatids have been disappointing. Many problems limiting success rate and hindering a wide application of this technique still remain unresolved, including the incomplete maturation of spermatid nuclear, oocyte activation and identification of a live spermatid.
Azoospermia ; therapy ; Cryopreservation ; Female ; Humans ; Male ; Pregnancy ; Sperm Injections, Intracytoplasmic ; methods ; Spermatozoa ; cytology

PURPOSE: Blastocyst transfer has been recommended to raise the implantation rate without affecting the pregnancy rate. The objective of this meta-analysis is to systematically evaluate whether the live birth rate and other pregnancy outcomes can be improved by blastocyst transfer compared with cleavage-stage embryos transfer. MATERIALS AND METHODS: EMBASE and MEDLINE databases were searched for papers published between March 2004 and March 2013. An extensive range of the electronic databases yielded initially 317 studies from which seven trials met the inclusion criteria for further analysis. Our outcome measures were the live birth rate, clinical pregnancy rate, implantation rate, ongoing pregnancy rate, multiple pregnancy rate, first trimester miscarriage rate and ectopic pregnancy rate. Fixed effects models were chosen to calculate the odds ratio (OR). RESULTS: Seven trials (n=1446 cases) were finally analyzed. Compared with cleavage-stage embryos transfer, the blastocyst transfer was statistically significantly associated with an increase in clinical pregnancy rate [OR 1.43; 95% confidence interval (CI), 1.15-1.78], implantation rate (OR 1.38; 95% CI, 1.09-1.74) and ongoing pregnancy rate (OR 2.15; 95% CI, 1.57-2.94), and also a reduction in the probability of first trimester miscarriage rate (OR 0.51; 95% CI, 0.30-0.87). The improvement in the live birth rate was also observed (OR 1.77; 95% CI, 1.32-2.37). Moreover, there was no evidence of difference in multiple pregnancy and ectopic pregnancy rates. CONCLUSION: The available evidences suggest that live birth and other pregnancy outcomes after fresh in vitro fertilization or intracytoplasmic sperm injection (IVF/ICSI) are significantly improved following blastocyst transfer as compared to cleavage-stage embryo transfer.
Birth Rate ; *Embryo Transfer ; Female ; Fertilization in Vitro/*methods ; Humans ; Pregnancy ; *Sperm Injections, Intracytoplasmic