Abstract
About 15 % of couples are unable to achieve a pregnancy due to a male factor diagnosis, and ICSI is seemingly the ideal treatment. ICSI remains the most popular choice of insemination even for simple, routine IVF cases, and a standard semen analysis alone is no longer inadequate in the modern infertility evaluation. Accordingly, the arrival of more sophisticated assays to measure the full impact and competency of the spermatozoon is welcome. To allow the embryonic genome to be read and expressed, the spermatozoon must release its oocyte-activating factor. Various assays are now being utilized to more fully ascertain the male gamete and establish its genetic integrity and its ability to sustain proper embryo development. While these attempts to select the ideal spermatozoon are laudable, they are still being tested and debated. Of note, these testing methods still do not address the clinical context where sperm numbers are extremely limited. As novel sperm selection methods continue to emerge, information regarding the long-term intergenerational effects of utilizing suboptimal sperm in IVF continues to accumulate. The increased emphasis on the gamete has stimulated the quest for new tools to more accurately diagnose and select individual spermatozoa prior to direct injection. This enables better counseling and treatment of couples while at the same time assuages worries associated with potentially passing a nonideal paternal genome onto the next generation. Reproductive specialists can thus aim to provide an ideal, singleton gestation for all patients seeking advanced reproductive assistance.
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Acknowledgments
We thank the clinicians, embryologists, andrologists, and scientists of The Ronald O. Perelman and Claudia Cohen Center for Reproductive Medicine and Urology Department, Weill Cornell Medical College. We are grateful to Theodore Paniza and Laura Park for their assistance in the laboratory work and to Dr. Brian Levine for generating a 3D model of the spermatozoon.
Conflict of Interest The authors disclose no conflict.
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Neri, Q.V., Cozzubbo, T., Cheung, S., Rosenwaks, Z., Palermo, G.D. (2015). Single Gamete Insemination Aiming at the Ideal Conceptus. In: Sills, E. (eds) Screening the Single Euploid Embryo. Springer, Cham. https://doi.org/10.1007/978-3-319-16892-0_6
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