Does intracytoplasmic morphologically selected sperm injection improve live birth rates compared to ICSI in men with infertility and raised sperm DNA fragmentation?
BAUS ePoster online library. Chen R. 06/23/21; 319047; p13-9
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Runzhi Chen
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Abstract
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Introduction: There is conflicting evidence on the role of intracytoplasmic morphologically selected sperm injection (IMSI) in assisted reproductive technology (ART), and whether it increases live birth rates (LBR) compared to conventional intracytoplasmic sperm injection (ICSI). In particular, the role of IMSI on ART outcomes in infertile men with raised sperm DNA fragmentation (SDF) is controversial.
Material and methods: We performed a retrospective analysis of 2,693 ICSI and 765 IMSI cycles from a single institution. Primary outcome measures included fertilisation rate, clinical pregnancy rate, miscarriage rate, and LBR. Subgroup analysis was performed on couples who had undergone SDF testing with the Comet assay. An average Comet score (ACS) of ≥29% was used as the threshold for elevation, as previously defined. Multiple regression analysis was conducted to identify variables which may predict LBR in both patient cohorts.
Results: LBR was comparable between ICSI and IMSI cycles in the overall study population; 18.1% and 21.0%, respectively. Subgroup analysis of men with raised SDF (Table 1) demonstrated a lower miscarriage rate (40.9% vs. 88.9%,p=0.003) and higher LBR (17.5% vs. 3.2%,p=0.003) in IMSI compared to ICSI cycles. In contrast, no differences in clinical outcomes were observed in men with normal SDF. Multiple regression analysis revealed that IMSI significantly increased the probability of LBR (OR 7.052 [95% CI 1.826-27.237],p=0.005) in men with raised SDF.
Conclusions: This study indicates that whilst IMSI may not be beneficial in the general infertile male population undergoing ART, it does improve LBR in men with raised SDF and male factor infertility.
Material and methods: We performed a retrospective analysis of 2,693 ICSI and 765 IMSI cycles from a single institution. Primary outcome measures included fertilisation rate, clinical pregnancy rate, miscarriage rate, and LBR. Subgroup analysis was performed on couples who had undergone SDF testing with the Comet assay. An average Comet score (ACS) of ≥29% was used as the threshold for elevation, as previously defined. Multiple regression analysis was conducted to identify variables which may predict LBR in both patient cohorts.
Results: LBR was comparable between ICSI and IMSI cycles in the overall study population; 18.1% and 21.0%, respectively. Subgroup analysis of men with raised SDF (Table 1) demonstrated a lower miscarriage rate (40.9% vs. 88.9%,p=0.003) and higher LBR (17.5% vs. 3.2%,p=0.003) in IMSI compared to ICSI cycles. In contrast, no differences in clinical outcomes were observed in men with normal SDF. Multiple regression analysis revealed that IMSI significantly increased the probability of LBR (OR 7.052 [95% CI 1.826-27.237],p=0.005) in men with raised SDF.
Conclusions: This study indicates that whilst IMSI may not be beneficial in the general infertile male population undergoing ART, it does improve LBR in men with raised SDF and male factor infertility.
Introduction: There is conflicting evidence on the role of intracytoplasmic morphologically selected sperm injection (IMSI) in assisted reproductive technology (ART), and whether it increases live birth rates (LBR) compared to conventional intracytoplasmic sperm injection (ICSI). In particular, the role of IMSI on ART outcomes in infertile men with raised sperm DNA fragmentation (SDF) is controversial.
Material and methods: We performed a retrospective analysis of 2,693 ICSI and 765 IMSI cycles from a single institution. Primary outcome measures included fertilisation rate, clinical pregnancy rate, miscarriage rate, and LBR. Subgroup analysis was performed on couples who had undergone SDF testing with the Comet assay. An average Comet score (ACS) of ≥29% was used as the threshold for elevation, as previously defined. Multiple regression analysis was conducted to identify variables which may predict LBR in both patient cohorts.
Results: LBR was comparable between ICSI and IMSI cycles in the overall study population; 18.1% and 21.0%, respectively. Subgroup analysis of men with raised SDF (Table 1) demonstrated a lower miscarriage rate (40.9% vs. 88.9%,p=0.003) and higher LBR (17.5% vs. 3.2%,p=0.003) in IMSI compared to ICSI cycles. In contrast, no differences in clinical outcomes were observed in men with normal SDF. Multiple regression analysis revealed that IMSI significantly increased the probability of LBR (OR 7.052 [95% CI 1.826-27.237],p=0.005) in men with raised SDF.
Conclusions: This study indicates that whilst IMSI may not be beneficial in the general infertile male population undergoing ART, it does improve LBR in men with raised SDF and male factor infertility.
Material and methods: We performed a retrospective analysis of 2,693 ICSI and 765 IMSI cycles from a single institution. Primary outcome measures included fertilisation rate, clinical pregnancy rate, miscarriage rate, and LBR. Subgroup analysis was performed on couples who had undergone SDF testing with the Comet assay. An average Comet score (ACS) of ≥29% was used as the threshold for elevation, as previously defined. Multiple regression analysis was conducted to identify variables which may predict LBR in both patient cohorts.
Results: LBR was comparable between ICSI and IMSI cycles in the overall study population; 18.1% and 21.0%, respectively. Subgroup analysis of men with raised SDF (Table 1) demonstrated a lower miscarriage rate (40.9% vs. 88.9%,p=0.003) and higher LBR (17.5% vs. 3.2%,p=0.003) in IMSI compared to ICSI cycles. In contrast, no differences in clinical outcomes were observed in men with normal SDF. Multiple regression analysis revealed that IMSI significantly increased the probability of LBR (OR 7.052 [95% CI 1.826-27.237],p=0.005) in men with raised SDF.
Conclusions: This study indicates that whilst IMSI may not be beneficial in the general infertile male population undergoing ART, it does improve LBR in men with raised SDF and male factor infertility.
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