Intracytoplasmic sperm injection
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Azoospermia is no longer a clear indication for using donor sperm. Aspiration of epididymal sperm or extraction of testicular sperm offers the same hope of pregnancy as ICSI using ejaculated sperm. Not even the high effectivenet8 of ICSI should be the reason for less intensive efforts to assess the exact cause of azoospermia, in particular with regard to genetic aspects. This work was supported by the Grant Agency of the Ministry of Health of the Czech Republic grant No. 3050-2.
Intracytoplasmic sperm injection (ICSI) is a procedure which dramatically eliminates the necessity to use donor sperm in androgenically conditioned sterility and enables almost all affected couples to achieve pregnancy.. The results in this group, till recently untreatable, are at least comparable with results achieved in the standard IVF programme. The standard success of the transport IVF programme was confirmed also in the transport IVF-ICSI programme. The transport of gametes does not influence the achieved results. It seems that for the results of the transport programme the indication and possibly other (gynaecological) factors of sterility are decisive. Intracytoplasmic sperm injection has become due to its effectivity an integral part of our IVF programme.
- MeSH
- infertilita terapie MeSH
- lidé MeSH
- spermie MeSH
- Check Tag
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
Intracytoplasmic sperm injection (ICSI) plays a unique role in the treatment of male infertility. ICSI results are not influenced by either sperm number, motility or sperm morphology. In our group we studied 90 cycles in which conventional WF and ICSI were performed on sibling oocytes in couples with borderline semen analysis (more than 50 000 sperm/oocyte). A higher number of A quality embryos was found in the ICSI oocyte group (40%/32%). In 38 % of IVF cycles no embryos were found, whereas with ICSI the absence decreased to only 12 %. In only 4 % of the cycles, the WF method was more succesful than that of ICSI treatment. In only 7 % of our combined group there were no embryos for transfer. The positive influence of ICSI on our centre results - 32 % pregnancy rate/ET and an 18 % baby take home rate - are discussed. In our retrospective study, ICSI is more successful than IVF alone and a combination of IVF and ICSI achieves the best results in the borderline sperm analysis group. An increased use of the ICSI technique in assisted reproduction can be expected in future.
Intracytoplasmic sperm infection (ICSI) is a very valuable method which implies a qualitative contribution to assisted reproduction and andrologically conditioned sterility, in particular. However, as one of the methods of cellular surgery it has its defined indications which must be respected.
The effect of extracellular sperm ubiquitination was examined from many aspects and the majority of existing studies negatively correlated the amount of highly ubiquitinated sperm cells in the sample with the ejaculate quality and the fertilization success rate. In the present study, we compared an early embryonic development up to blastocyst stage in the pig using two defined sperm cell populations sorted by flow cytometry (FACS) based on the rate of the extracellular ubiquitination. This novel approach allows studying the direct effect of extracellular ubiquitin (eUb), which is a marker for epididymal recognition and degradation of defective sperm cells. We further examined the hypothesis that eUb could be recognized directly in the ooplasm. In the porcine model, the significance of results might be seriously affected by a high variability among sperm cell doses from individual boars as well as by the variability among separate sample collections. To overcome this obstacle, we used cryopreserved sperm cells from a single dose. Comparison of an early embryonic development employing intracytoplasmic sperm cell injection (ICSI) with cryopreserved (frozen/thawed, F/T) and fresh sperm cells did not reveal significant difference regarding blastocyst formation rate. We also observed no difference in the male and female pronuclei formation and the first zygote cleavage after fertilization of oocytes with high or non-ubiquitinated sperm cells sorted by FACS. However, results of the early embryonic development to the blastocyst stage showed the difference between both experimental groups (16.67% of blastocysts in non-ubiquitinated group vs. 6.20% of blastocyst in the high-ubiquitinated group, P < 0.001). We further confirmed the negative effect of eUb by the masking of Ub epitopes with the appropriate primary antibody in fresh sperm cells prior to ICSI. This procedure improved the blastocyst formation rate from 14.19% in the untreated group to 24.03% concerning antibody masked sperms (P < 0.01). We conclude our results support a generally accepted hypothesis concerning the negative correlation of the presence of eUb on the sperm cell membrane and developmental competence of fertilized oocytes. However, experiments with masking Ub antibody indicate the direct negative effect of the membrane ubiquitin rather than sperm cell quality on the early embryonic development to the blastocyst stage, at least in the porcine model.
- MeSH
- blastocysta fyziologie MeSH
- intracytoplazmatické injekce spermie veterinární MeSH
- kryoprezervace veterinární MeSH
- kultivace embrya veterinární MeSH
- oocyty fyziologie MeSH
- prasata * MeSH
- průtoková cytometrie MeSH
- spermie fyziologie MeSH
- ubikvitinace fyziologie MeSH
- uchování spermatu veterinární MeSH
- zvířata MeSH
- Check Tag
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- zvířata MeSH
- Publikační typ
- časopisecké články MeSH
The quandary known as the Intracytoplasmic Sperm Injection (ICSI) paradox is found at the juncture of Assisted Reproductive Technology (ART) and 'andrological ignorance' - a term coined to denote the undervalued treatment and comprehension of male infertility. The prevalent use of ICSI as a solution for severe male infertility, despite its potential to propagate genetically defective sperm, consequently posing a threat to progeny health, illuminates this paradox. We posit that the meteoric rise in Industrial Revolution 4.0 (IR 4.0) and Artificial Intelligence (AI) technologies holds the potential for a transformative shift in addressing male infertility, specifically by mitigating the limitations engendered by 'andrological ignorance.' We advocate for the urgent need to transcend andrological ignorance, envisaging AI as a cornerstone in the precise diagnosis and treatment of the root causes of male infertility. This approach also incorporates the identification of potential genetic defects in descendants, the establishment of knowledge platforms dedicated to male reproductive health, and the optimization of therapeutic outcomes. Our hypothesis suggests that the assimilation of AI could streamline ICSI implementation, leading to an overall enhancement in the realm of male fertility treatments. However, it is essential to conduct further investigations to substantiate the efficacy of AI applications in a clinical setting. This article emphasizes the significance of harnessing AI technologies to optimize patient outcomes in the fast-paced domain of reproductive medicine, thereby fostering the well-being of upcoming generations.
- MeSH
- asistovaná reprodukce MeSH
- intracytoplazmatické injekce spermie * MeSH
- lidé MeSH
- mužská infertilita * diagnóza genetika terapie MeSH
- sperma MeSH
- umělá inteligence MeSH
- Check Tag
- lidé MeSH
- mužské pohlaví MeSH
- Publikační typ
- dopisy MeSH
Cíl studie: Vyhodnotit kvalitu embryí po ICSI v závislosti na rychlosti nástupu prvního buněčného dělení. Typ studie: Prospektivní studie. Název a sídlo pracoviště: Centrum asistované reprodukce, Porod.-gynekologická klinika FN a LF UP, Olomouc. Metoda: Bylo hodnoceno 1116 embryí získaných v cyklech ICSI (IntraCytoplasmic Sperm Injection) v období 2001–2004. Kontrola nástupu prvního buněčného dělení probíhala za 22–27 hodin od ukončení ICSI a embrya byla rozdělena do tří skupin podle rychlosti dělení: early cleavage (EC) embrya, jestliže u nich již proběhlo první buněčné dělení, break down pronuclear (BDPN) embrya, u kterých došlo pouze k rozpuštění karyolemy, a pronuclear (PN) embrya, která zůstávala ve stadiu prvojader. Stupeň fragmentace byl v těchto skupinách hodnocen 2. den kultivace ve čtyřech kategoriích: A – embrya s pravidelnými blastomerami, bez fragmentací, B – embrya s nepravidelnými blastomerami nebo s fragmentací do 30 %, C – embrya s fragmentací 30–50 % a D – embrya s fragmentací nad 50 %. U všech sledovaných embryí byla hodnocena rychlost dalšího dělení a průměrný počet blastomer 2. a 3. den kultivace. Statistické zpracování bylo provedeno v Centru výpočetní techniky UP Olomouc pomocí dvouvýběrového t-testu a χ2 testu. Výsledky: Z 1116 embryí bylo 37,4 % embryí EC, 33,1 % BDPN a 29,5 % PN. Zjištěné rozdíly ve stupni fragmentace mezi skupinami byly statisticky průkazné (p = 0,000). EC embrya byla v 52 % zcela bez fragmentů, zatímco 48 % PN embryí bylo s vysokým stupněm fragmentace. K zástavě dělení došlo pouze ve skupině PN embryí (3,3 %). V rychlosti dělení (2. i 3. den kultivace) je rozdíl mezi skupinami statisticky průkazný (p = 0,000). Průměrný počet blastomer 2. den kultivace je statisticky průkazný mezi všemi skupinami (p = 0,000), třetí den je průkazný rozdíl jen mezi EC a BDPN vs. PN embryi (p = 0,000). Závěr: Hodnocení rychlosti nástupu prvního buněčného dělení je vhodným parametrem při výběru embrya k přenosu. EC embrya jsou embrya s „lepší“ morfologií a mají větší průměrný počet blastomer než obě zbývající skupiny.
Objective: To evaluate morphological parameters of embryos obtained in the process of ICSI. Design: A prospective study. Setting: Centre of Assisted Reproduction, Dept. of Obstetrics and Gynecology, Palacký University Medical School, Olomouc. Methods: In the present study 1116 embryos developing after ICSI (IntraCytoplasmic Sperm Injection) procedure in the period of 2001-2004 were evaluated. The beginning of the mitotic cleavage was assessed within the interval of 22–27 hours after insemination. The embryos were divided into three groups according to the speed of their division as Early Cleavage (EC) embryos, where two blastomeres were present at the time of assessment, Break Down ProNuclei stage (BDPN) where the pronuclei had already disappeared, and ProNuclei (PN) embryos, where both pronuclei were still present. In these groups the degree of fragmentation was evaluated on day two of cultivation and embryos were divided into four categories as: A – regular blastomeres, without fragmentation, B - irregular blastomeres or fragmentation below 30%, C - fragmentation 30 - 50%, D - fragmentation above 50%. The speed of further cleavage and average number of blastomeres were evaluated on day two and three of cultivation. Statistical analysis was preformed at the Palacký University Computer Centre. The χ2 test and t-test for independent samples were used. Results: EC embryos were found in 37.4%, BDPN in 33.1% and PN in 29.5%. The degree of fragmentation between evaluated groups of embryos were statistically significant (p = 0.000). EC embryos were less fragmented (p = 0.000), had more blastomeres at the time of evaluation (p = 0.000) and their speed of cleavage was faster (p = 0.000). The cleavage of EC embryos was faster in comparison with the PN group (p = 0.000), but there were no significant differences between the EC and BDPN groups on day two of cultivation. On day three significant differences were found also between the EC and BDPN groups (p = 0.000). The embryonic developmental arrest was found only in PN embryos. Conclusion: The speed of the first cell cleavage is a useful additional criterion for the embryo selection for embryotransfer. EC embryos usually have better morphology and more blastomeres than the BPDN and PN ones.
- MeSH
- blastomery MeSH
- buněčná diferenciace MeSH
- buněčné dělení MeSH
- embryo savčí anatomie a histologie fyziologie MeSH
- fertilizace in vitro MeSH
- finanční podpora výzkumu jako téma MeSH
- intracytoplazmatické injekce spermie MeSH
- lidé MeSH
- prospektivní studie MeSH
- řízení kvality MeSH
- Check Tag
- lidé MeSH
