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Correlation Between Sperm Morphology by Kruger’s Strict Criteria and the Outcome of ICSI in IVF Cycles
was added to the cryoprotectant solutions at a concentration of 10ug/ml. Post -thaw survival, embryo morphology and blastocyst development were assessed after thawing. At termination of the experiment, cell nuclei were labeled with polynucleotide specific fluorochromes and cell counts were performed. All results were assessed using the student T-test and by chi square analysis. RESULTS: Mouse embryo survival and blastomere cell number at thaw were compared after cryopreservation with traditional slow freeze methodology and vitrification on cryoloops, in the presence and absence of hyaluron. All treatment groups had over 98% post-thaw survival. A total of 92 embryos were available for analysis after thaw. Overall blastomere number in thawed blastocysts is shown below.
CONCLUSION: Hyaluron supplementation of cryoprotectant medium did not appear to offer any advantage. Cryopreservation of mouse blastocysts by vitrification was superior to the slow freeze methodology . Supported by: None P-835 Correlation Between Sperm Morphology by Kruger’s Strict Criteria and the Outcome of ICSI in IVF Cycles. M. Gvakharia, Z. L. Beri, G. D. Adamson. Fertility Physicians of Northern California, San Jose and Palo Alto, CA. OBJECTIVE: The aim of this study was to investigate the correlation between strict sperm morphology determined using Kruger’s strict criteria and the outcome of ICSI in IVF cycles. DESIGN: Retrospective analysis of strict morphology parameters and outcomes of IVF-ICSI cycles in a private clinic setting between 1999 and 2004. MATERIALS AND METHODS: The study included 951 consecutive couples with maternal age ⬍38 years (mean maternal age 32.9⫾3.2 years), undergoing IVF with the ICSI procedure for infertility treatment. These patients were divided into the following groups: group A - patients with normal sperm morphology of ⱖ5% (n⫽309), group B - patients with normal morphology of 4 % (n⫽93), group C- patients with normal morphology of 3 % (n⫽121), group D - patients with normal morphology of 2 % (n⫽152), group E- patients with normal morphology of 1% (n⫽116), and group F - patients with normal morphology of 0% (n⫽160). Fertilization rates, embryo cleavage rates and ongoing clinical pregnancy rates were compared between these groups. Fischer’s exact test was used to determine statistical significance of study findings. RESULTS: Overall, 10,569 oocytes were injected with normal fertilization and embryo cleavage rates of 70 % and 98 %, respectively. Ongoing pregnancy rate per oocyte retrieval in IVF-ICSI patients was 33%. Normal fertilization results in different groups were: group A-70%, group B-73%, group C-72%, group D-72%, group E-67%, and group F-65%. Fertilization rate was statistically significantly lower in groups E and F when compared with group A (p⬍0.05 and p⬍0.001, respectively). There were no statistically significant differences in fertilization rates among other groups of patients. Cleavage rates of fertilized oocytes in different groups were: group A-97%, group B-98%, group C-95%, group D-98%, group E-97%, and group F-99%. There were no statistically significant differences in cleavage rates among these groups of patients. Ongoing pregnancy rates in different groups were: group A-32%, group B-38%, group C-38%, group D-32%, group E-29%, and group F-33%. There were no statistically significant differences in pregnancy rates among these groups of patients. CONCLUSION: These results indicate that slightly lower fertilization rates after ICSI should be anticipated in patients with extremely poor sperm morphology. However, fertilized oocytes from patients with poor sperm
FERTILITY & STERILITY威
morphology divide and result in pregnancies at a rate not different than embryos from patients with normal sperm morphology. Supported by: None
P-836 Sperm Motion Characteristics May Discriminate Fertile From Infertile Men With Normal Parameters. F. F. Pasqualotto, A. Agarwal, B. P. Sobreiro, J. Hallak, E. B. Pasqualotto, A. M. Lucon. Universidade de Caxias do Sul and Conception, Centro de Reproducao Humana, Caxias do Sul, Brazil; Cleveland Clinic Foundation, Cleveland, OH; University of Sao Paulo, Sao Paulo, Brazil. OBJECTIVE: When computer assisted semen analysis systems were brought into the marketplace, it was suggested that these machines could replace the technician; however, this hope was not realized when these machines failed to provide accurate results. On the other hand, these machines are capable of providing movement characteristics of spermatozoa. The goal of our study was to evaluate aspects of sperm movement (kinetics) in a fertile and infertile population. DESIGN: Retrospective study at a tertiary care institution. MATERIALS AND METHODS: From September 1999 to August 2002, 670 infertile men (Group A) and 889 vasectomies for voluntary sterilization (fertile men; Group B) purposes were included in our study. The mean age was 38.04 ⫾ 7.14 in the infertile group and 35.04 ⫾ 6.14 in the fertile group (p ⬎ 0.05). We compared sperm concentration, motility, straight-line velocity (VSL), curvilinear velocity (VCL), average path velocity (VAP), linearity (LIN), and amplitude of lateral head displacement (ALH) between the two groups. In addition, we compared the sperm motion characteristics between fertile (n ⫽ 280) and infertile men (n ⫽ 175) with normal sperm motility according to the World Health Organization. We used ANOVA for statistical evaluation. RESULTS: Differences were seen (p ⬍ 0.0001) between groups A and B in sperm concentration (40.29 ⫾ 53.23 and 112.25 ⫾ 81.62) and sperm motility (36.94 ⫾ 28.6 and 60.83 ⫾ 15.4). Also, differences were detected in the sperm motion characteristics evaluated (p ⬍ 0.0001): VSL (21.23 ⫾ 19.22 and 40.41 ⫾ 10.36), VCL (40.81 ⫾ 43.5 and 52.27 ⫾ 16.65), VAP (26.13 ⫾ 22.52 and 48.36 ⫾ 10.91), LIN (32.44 ⫾ 26.5 and 55.21 ⫾ 3.12), and ALH (1.86 ⫾ 1.92 and 3.09 and 0.94). VSL (P ⫽ 0.001), VAP (P ⫽ 0.001) and LIN (P ⫽ 0.017) were lower in infertile men with normal semen analysis compared to normal fertile men. However, VCL (P ⫽ 0.143) and ALH (P ⫽ 0.698) did not differ between patients with normal semen analysis and donors. CONCLUSION: Certain sperm motion characteristics measured by CASA may have the power to answer why patients with normal semen analysis may be infertile. However, more studies should be done to evaluate the role of sperm motion characteristics in male infertility investigation. Supported by: None
P-837 Evaluation of Sperm 24-Hour Motility and Sperm Recovery After Density Gradient Separation in Relation to Fertilization Potential. C. Petrella, B. Glazar, K. Thrift, J. Garcia, Y. Zhao. Division of Reproductive Endocrinology and Infertility, Department of Gyn/Ob, Johns Hopkins University School of Medicine, Baltimore, MD. OBJECTIVE: Several studies indicate that advanced semen analysis including sperm recovery during swim-up and sperm survival after 24 hours may predict IVF or IUI success. We have included sperm recovery and 24-hour motility as part of the profile for the semen analysis in the past years. This study is to determine if sperm recovery through a density gradient separation and sperm motility after a 24-hour incubation in addition to a routine semen analysis during the male fertility evaluation can predict fertilization potential for IVF. DESIGN: Retrospective study. MATERIALS AND METHODS: 150 specimens with normal semen parameters measured by WHO criteria and corresponding 227 IVF cycles were included in the study. Semen aliquots from each specimen were processed by a 2-step discontinuous gradient separation. Rate of motile sperm recovery and sperm motility after 24-hour incubation were documented. Thereafter these
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CONCLUSION: Hyaluron supplementation of cryoprotectant medium did not appear to offer any advantage. Cryopreservation of mouse blastocysts by vitrification was superior to the slow freeze methodology . Supported by: None P-835 Correlation Between Sperm Morphology by Kruger’s Strict Criteria and the Outcome of ICSI in IVF Cycles. M. Gvakharia, Z. L. Beri, G. D. Adamson. Fertility Physicians of Northern California, San Jose and Palo Alto, CA. OBJECTIVE: The aim of this study was to investigate the correlation between strict sperm morphology determined using Kruger’s strict criteria and the outcome of ICSI in IVF cycles. DESIGN: Retrospective analysis of strict morphology parameters and outcomes of IVF-ICSI cycles in a private clinic setting between 1999 and 2004. MATERIALS AND METHODS: The study included 951 consecutive couples with maternal age ⬍38 years (mean maternal age 32.9⫾3.2 years), undergoing IVF with the ICSI procedure for infertility treatment. These patients were divided into the following groups: group A - patients with normal sperm morphology of ⱖ5% (n⫽309), group B - patients with normal morphology of 4 % (n⫽93), group C- patients with normal morphology of 3 % (n⫽121), group D - patients with normal morphology of 2 % (n⫽152), group E- patients with normal morphology of 1% (n⫽116), and group F - patients with normal morphology of 0% (n⫽160). Fertilization rates, embryo cleavage rates and ongoing clinical pregnancy rates were compared between these groups. Fischer’s exact test was used to determine statistical significance of study findings. RESULTS: Overall, 10,569 oocytes were injected with normal fertilization and embryo cleavage rates of 70 % and 98 %, respectively. Ongoing pregnancy rate per oocyte retrieval in IVF-ICSI patients was 33%. Normal fertilization results in different groups were: group A-70%, group B-73%, group C-72%, group D-72%, group E-67%, and group F-65%. Fertilization rate was statistically significantly lower in groups E and F when compared with group A (p⬍0.05 and p⬍0.001, respectively). There were no statistically significant differences in fertilization rates among other groups of patients. Cleavage rates of fertilized oocytes in different groups were: group A-97%, group B-98%, group C-95%, group D-98%, group E-97%, and group F-99%. There were no statistically significant differences in cleavage rates among these groups of patients. Ongoing pregnancy rates in different groups were: group A-32%, group B-38%, group C-38%, group D-32%, group E-29%, and group F-33%. There were no statistically significant differences in pregnancy rates among these groups of patients. CONCLUSION: These results indicate that slightly lower fertilization rates after ICSI should be anticipated in patients with extremely poor sperm morphology. However, fertilized oocytes from patients with poor sperm
FERTILITY & STERILITY威
morphology divide and result in pregnancies at a rate not different than embryos from patients with normal sperm morphology. Supported by: None
P-836 Sperm Motion Characteristics May Discriminate Fertile From Infertile Men With Normal Parameters. F. F. Pasqualotto, A. Agarwal, B. P. Sobreiro, J. Hallak, E. B. Pasqualotto, A. M. Lucon. Universidade de Caxias do Sul and Conception, Centro de Reproducao Humana, Caxias do Sul, Brazil; Cleveland Clinic Foundation, Cleveland, OH; University of Sao Paulo, Sao Paulo, Brazil. OBJECTIVE: When computer assisted semen analysis systems were brought into the marketplace, it was suggested that these machines could replace the technician; however, this hope was not realized when these machines failed to provide accurate results. On the other hand, these machines are capable of providing movement characteristics of spermatozoa. The goal of our study was to evaluate aspects of sperm movement (kinetics) in a fertile and infertile population. DESIGN: Retrospective study at a tertiary care institution. MATERIALS AND METHODS: From September 1999 to August 2002, 670 infertile men (Group A) and 889 vasectomies for voluntary sterilization (fertile men; Group B) purposes were included in our study. The mean age was 38.04 ⫾ 7.14 in the infertile group and 35.04 ⫾ 6.14 in the fertile group (p ⬎ 0.05). We compared sperm concentration, motility, straight-line velocity (VSL), curvilinear velocity (VCL), average path velocity (VAP), linearity (LIN), and amplitude of lateral head displacement (ALH) between the two groups. In addition, we compared the sperm motion characteristics between fertile (n ⫽ 280) and infertile men (n ⫽ 175) with normal sperm motility according to the World Health Organization. We used ANOVA for statistical evaluation. RESULTS: Differences were seen (p ⬍ 0.0001) between groups A and B in sperm concentration (40.29 ⫾ 53.23 and 112.25 ⫾ 81.62) and sperm motility (36.94 ⫾ 28.6 and 60.83 ⫾ 15.4). Also, differences were detected in the sperm motion characteristics evaluated (p ⬍ 0.0001): VSL (21.23 ⫾ 19.22 and 40.41 ⫾ 10.36), VCL (40.81 ⫾ 43.5 and 52.27 ⫾ 16.65), VAP (26.13 ⫾ 22.52 and 48.36 ⫾ 10.91), LIN (32.44 ⫾ 26.5 and 55.21 ⫾ 3.12), and ALH (1.86 ⫾ 1.92 and 3.09 and 0.94). VSL (P ⫽ 0.001), VAP (P ⫽ 0.001) and LIN (P ⫽ 0.017) were lower in infertile men with normal semen analysis compared to normal fertile men. However, VCL (P ⫽ 0.143) and ALH (P ⫽ 0.698) did not differ between patients with normal semen analysis and donors. CONCLUSION: Certain sperm motion characteristics measured by CASA may have the power to answer why patients with normal semen analysis may be infertile. However, more studies should be done to evaluate the role of sperm motion characteristics in male infertility investigation. Supported by: None
P-837 Evaluation of Sperm 24-Hour Motility and Sperm Recovery After Density Gradient Separation in Relation to Fertilization Potential. C. Petrella, B. Glazar, K. Thrift, J. Garcia, Y. Zhao. Division of Reproductive Endocrinology and Infertility, Department of Gyn/Ob, Johns Hopkins University School of Medicine, Baltimore, MD. OBJECTIVE: Several studies indicate that advanced semen analysis including sperm recovery during swim-up and sperm survival after 24 hours may predict IVF or IUI success. We have included sperm recovery and 24-hour motility as part of the profile for the semen analysis in the past years. This study is to determine if sperm recovery through a density gradient separation and sperm motility after a 24-hour incubation in addition to a routine semen analysis during the male fertility evaluation can predict fertilization potential for IVF. DESIGN: Retrospective study. MATERIALS AND METHODS: 150 specimens with normal semen parameters measured by WHO criteria and corresponding 227 IVF cycles were included in the study. Semen aliquots from each specimen were processed by a 2-step discontinuous gradient separation. Rate of motile sperm recovery and sperm motility after 24-hour incubation were documented. Thereafter these
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