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Intracytoplasmic Injection with Suboptimal Spermatozoa

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Non-Invasive Sperm Selection for In Vitro Fertilization

Abstract

In vitro fertilization has been extensively used for the alleviation of human infertility since the late 1970s. However, because spermatozoa failed to fertilize in many cases of male factor indication, a number of gamete manipulation techniques emerged to overcome this inability. The implementation of microsurgical techniques, particularly ICSI, has made possible to overcome defects in male gamete production and dysfunction to allow male partners to fertilize oocytes at rates that previously would have been deemed unachievable. In the last 19 years at Cornell, we have performed thus far a total of 34,425 ART cycles by ICSI and in vitro insemination. To evaluate differences in performance between these most common insemination methods, we compared embryological outcomes and clinical pregnancy rates between standard in vitro insemination and ICSI. While it appeared that fertilization was lower in IVF than with ICSI, this was confirmed even after correcting fertilization for retrieved oocytes. ICSI still yielded more oocytes fertilized than IVF (60.5 % vs. 67.6 %; P = 0.0001) as well as higher term pregnancies (P = 0.0002). The origin of the spermatozoa used for ICSI was also described and outcomes compared. In addition, considerations on the efficacy of current methods to select the ideal male gamete are elucidated and concerns related to the offspring generated from couples with severe male factor are discussed.

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Acknowledgements

We are most grateful to the Andrology and Embryology Laboratories and particularly to the clinicians, scientists, and nursing staff of The Ronald O. Perelman & Claudia Cohen Center for Reproductive Medicine.

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Authors and Affiliations

  1. The Ronald O. Perelman and Claudia Cohen Center for Reproductive Medicine, Weill Cornell Medical College, 1305 York Avenue, Suite 720, New York, NY, 10021, USA

    Gianpiero D. Palermo MD, PhD & Queenie V. Neri BSc, MSc

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  1. Gianpiero D. Palermo MD, PhD
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  2. Queenie V. Neri BSc, MSc
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Correspondence to Gianpiero D. Palermo MD, PhD .

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Editors and Affiliations

  1. Cleveland Clinic, Andrology Center & Center for Reproductive Medicine, Cleveland, Ohio, USA

    Ashok Agarwal

  2. Fertility - Centro de Fertilização Assistida, São Paulo, São Paulo, Brazil

    Edson Borges Jr.

  3. Instituto Sapientiae - Centro de Estudos e Pesquisa em Reprodução Assistida, São Paulo, São Paulo, Brazil

    Amanda S. Setti

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Palermo, G.D., Neri, Q.V. (2015). Intracytoplasmic Injection with Suboptimal Spermatozoa. In: Agarwal, A., Borges Jr., E., Setti, A. (eds) Non-Invasive Sperm Selection for In Vitro Fertilization. Springer, New York, NY. https://doi.org/10.1007/978-1-4939-1411-1_2

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  • DOI: https://doi.org/10.1007/978-1-4939-1411-1_2

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