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[How to select the spermatozoon in ICSI?]
1Service d'histologie-embryologie-cytogénétique-CECOS, centre hospitalier universitaire Jean-Verdier, Assistance Publique-Hôpitaux de Paris, avenue du 14-Juillet, 93140 Bondy, France.
Gynecologie, Obstetrique & Fertilite
|September 23, 2014
Summary
Selecting sperm for intracytoplasmic sperm injection (ICSI) can be challenging. Advanced techniques like sperm processing, IMSI, and functional tests aid embryologists in choosing viable sperm, potentially improving ICSI outcomes.
Area of Science:
- Reproductive biology
- Embryology
- Andrology
Background:
- Standard ICSI sperm selection relies on motility and morphology.
- Severe male factor infertility (oligoasthenozoospermia, non-obstructive azoospermia) necessitates advanced sperm selection methods.
- Testicular sperm retrieval often requires specialized techniques for selection.
Purpose of the Study:
- To review and evaluate advanced sperm selection techniques for ICSI.
- To explore methods beyond conventional motility and morphology assessment.
- To identify potential improvements in ICSI outcomes through enhanced sperm selection.
Main Methods:
- Review of existing literature on sperm processing and selection techniques.
- Discussion of Intracytoplasmic Morphologically Selected Sperm Injection (IMSI).
- Exploration of functional tests (hyaluronic acid binding, zona pellucida binding, pentoxifylline test, HOS-test) and structural assessments (birefringence).
Main Results:
- Sperm processing may reduce DNA fragmentation, potentially improving ICSI success.
- IMSI shows promise for specific indications like severe teratozoospermia and recurrent ICSI failure.
- Functional and structural tests can aid in selecting viable sperm, especially in cases of akinetospermia.
Conclusions:
- Advanced sperm selection methods offer potential benefits for challenging ICSI cases.
- Further large-scale studies are needed to validate the efficacy and indications of these techniques.
- Standardization and wider application require more evidence and precise guidelines.