Different oocyte fertilization methods and their relationship to the effectiveness of assisted reproductive technology programs in the treatment of infertility

Dudarova A.Kh., Smolnikova V.Yu., Makarova N.P., Gorshinova V.K., Popova A.Yu., Gamidov S.I., Kalinina E.A.

Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health of Russia, Moscow 117997, Ac. Oparina str. 4, Russia
Objective. To determine the relationship between the type of oocyte fertilization, embryological parameters (oocyte fertilization rate; blastulation rate), and clinical outcomes in assisted reproductive technology (ART) programs using different fertilization procedures (vitro fertilization (IVF), intracytoplasmic sperm injection (ICSI), and physiological intracytoplasmic sperm injection (PICSI).
Subjects and methods. A prospective case-control study covered 196 married couples undergoing the program of IVF, IVF/ICSI), IVF/PICSI. The couples were divided into 3 groups according to the type of fertilization: 1) 32 couples who underwent IVF; 2) 105 couples who had ICSI; 3) 59 couples who had PICSI. The embryological parameters (oocyte fertilization rate; blastulation rate) and clinical outcomes in the ART programs were assessed.
Results. Our investigation conducted in the compared groups showed a statistically significant association between the type of oocyte fertilization and the rate of implantation. There were significant differences in implantation rates between Groups 1 and 2 (χ2 = 6.0; P = 0.014). The implantation rates were 40.5% in Group 1, 33.1% in Group 2, and 50% in Group 2). A statistically significant difference was also found in clinical pregnancy rates. In the PICSI group where spermatozoa were selected for their hyaluronic acid (HA)-binding ability before ICSI), the clinical pregnancy rate was higher and equal to 59.3% (in 35 patients; it was 40.6% (in 13 married couples) in Group 1 (conventional IVF) and 38.1% (in 40 patients) in Group 2. There were statistically significant differences between the rate of oocyte fertilization and that of blastulation. However, the rate of non-developing pregnancy in Group 1 (conventional IVF) was 7.7% while in the ICSI and PICSI groups it was 31 and 11%, respectively, which confirms the fundamental role of physiological sperm selection during conventional fertilization (IVF) and in the use of HA as a selector of gametes (PICSI). Significant differences in live birth rates per pregnancies after ART programs were also identified in favor of Group 1 (conventional IVF) and Group 3 (physiological selection of male gametes for ICSI) as compared with Group 2 (ICSI). Furthermore, the groups compared showed a statistically significant difference in live birth rates per embryo transfer into the uterus. In Group 1 (conventional IVF), the live birth rate was 36.4% calculated per embryo, whereas it was 27.6% in Group II (IVF/ICSI) and 53.30% in Group 3 (selection of spermatozoa for their HA-binding ability).
Conclusion. The data collected for today confirm the prospects of studying the significance of various modern methods of male reproductive cells selection for the purpose of differential approach to the treatment of married couples. Studies demonstrate encouraging results that can be applied in clinical practice not only to optimize the choice of the fertilization technique, but also to expand the scope of the examination before the IVF program.

Keywords

in vitro fertilization
infertility
hyaluronic acid
sperm selection
intracytoplasmic sperm injection
physiological intracytoplasmic sperm injection
assisted reproductive technologies

Supplementary Materials

  1. Fig. 1. Distribution by frequency of occurrence of infertility factors in the compared groups
  2. Fig. 2. Frequency of occurrence of different types of pathoospermia in the compared groups
  3. Fig. 3. Frequency of undeveloped pregnancies and live births in the study groups

References

1. World Health Organization. World Bank. World report on disability. 2011. Available at: http://www.who.int/disabilities/word report/2011/en/

2. WHO. Laboratory manual for the examination and processing of human semen. 5th ed. Geneva: World Health Organization; 2014.

3. Inhorn M.C., Patrizio P. Infertility around the globe: new thinking on gender, reproductive technologies and global movements in the 21st century. Hum. Reprod. Update. 2015; 21(4): 411-26.

4. Agarwal A., Mulgund A., Hamada A., Chyatte M.R. Reprod. A unique view on male infertility around the globe. Reprod. Biol. Endocrinol. 2015; 13: 37.

5. Stone B.A., Alex A., Werlin L.B., Marrs R.P. Age thresholds for changes in semen parameters in men. Fertil. Steril. 2013; 100(4): 952-8.

6. Irvine D.S. Epidemiology and aetiology of male infertility. Hum. Reprod. 1998; 13(Suppl. 1): 33-44.

7. Yagci A., Murk W., Stronk J., Huszar G. Spermatozoa bound to solid state hyaluronic acid show chromatin structure with high DNA chain integrity: an acridine orange fluorescence study. J. Androl. 2010; 31(6): 566-72.

8. Guérin J.F., Benchaib M. Are IVF results predictable through the analysis of sperm DNA fragmentation? Gynecol. Obstet. Fertil. 2003; 31(12): 1058-60.

9. Virro M.R., Larson-Cook K.L., Evenson D.P. Sperm chromatin structure assay (SCSA) parameters are related to fertilization, blastocyst development, and ongoing pregnancy in in vitro fertilization and intracytoplasmic sperm injection cycles. Fertil. Steril. 2004; 81(5): 1289-95.

10. Huszar G., Ozenci C.C., Cayli S., Zavaczki Z., Hansch E., Vigue L. Hyaluronic acid binding by human sperm indicates cellular maturity, viability, and unreacted acrosomal status. Fertil. Steril. 2003; 79(Suppl. 3): 1616-24.

11. Simpson J.L., Lamb D.J. Genetic effects of intracytoplasmic sperm injection. Semin. Reprod. Med. 2001; 19(3): 239-49.

12. Jakab A., Sakkas D., Delpiano E., Cayli S., Kovanci E., Ward D. et al. Intracytoplasmic sperm injection: a novel selection method for sperm with normal frequency of chromosomal aneuploidies. Fertil. Steril. 2005; 84(6):1665-73.

13. Prinosilova P., Kruger T., Sati L., Ozkavukcu S., Vigue L., Kovanci E., Huszar G. Selectivity of hyaluronic acid binding for spermatozoa with normal Tygerberg strict morphology. Reprod. Biomed. Online. 2009; 18(2): 177-83.

14. Berkovitz A., Eltes F., Yaari S., Katz N., Barr I., Fishman A., Bartoov B. The morphological normalcy of the sperm nucleus and pregnancy rate of intracytoplasmic injection with morphologically selected sperm. Hum. Reprod. 2005; 20(1): 185-90.

15. Boitrelle F., Guthauser B., Alter L., Bailly M., Bergere M., Wainer R. et al. High-magnification selection of spermatozoa prior to oocyte injection: confirmed and potential indications. Reprod. Biomed. Online. 2014; 28(1): 6-13.

16. Parmegiani L., Cognigni G.E., Ciampaglia W., Pocognoli P., Marchi F., Filicori M. Efficiency of hyaluronic acid (HA) sperm selection. J. Assist. Reprod. Genet. 2010; 27(1): 13-6.

17. Alpha Scientists in Reproductive Medicine and ESHRE Special Interest Group of Embryology. The Istanbul consensus workshop on embryo assessment: proceedings of an expert meeting. Hum. Reprod. 2011; 26(6): 1270-83.

18. Ovchinnikov R.I., Gamidov S.I., Popova A.Yu., Isbaev S.Kh., Ushakova I.V., Golubeva O.N. Causes of reproductive losses in men – fragmentation of the DNA of spermatozoa. Russian Medical Journal. 2015; 23(11): 634-8. (in Russian)

19. Feskov A.M., Feskova I.A., Zhilkova E.S., Somova E.V., Zozulina A.N. The effect of DNA fragmentation and the disturbance of the process of maturation of spermatozoa on the degree of blastulation in the IVF program. Available at: www.uarm.org.ua (in Russian)

20. Findikli N., Kahraman S., Kumtepe Y. Assessment of DNA fragmentation and aneuploidy on poor quality human embryos. Reprod. Biomed. Online. 2004; 8(2): 196-206.

21. Seli E., Sakkas D. Spermatozoal nuclear determinants of reproductive outcome: implications for ART. Hum. Reprod. Update. 2005; 11(4): 337-49.

22. Worrilow K.C., Eid S., Matthews J., Pelts E., Khoury C., Liebermann J. Multi-site clinical trial evaluating PICSI, a method for selection of hyaluronan bound sperm (HBS) for use in ICSI: improved clinical outcomes. Hum. Reprod. 2010; 25(Suppl. 1): i7.

23. Gamidov S.I., Ovchinnikov R.I., Popova A.Yu., Golubeva O.N., Ushakova I.V. The role of men in the habitual miscarriage of a wife. Urologiya. 2016; Suppl. 1: 35-43. (in Russian)

24. Boivin J., Bunting L., Collins J.A., Nygren K.G. International estimates of infertility prevalence and treatment-seeking: potential need and demand for infertility medical care. Hum. Reprod. 2007; 22(6): 1506-12.

25. Sartorius G.A., Nieschlag E. Paternal age and reproduction. Hum. Reprod. Update. 2010; 16: 65-79.

26. Aitken R.J. Age, the environment, and our reproductive future: bonking baby boomers and the future of sex. Reproduction. 2014; 147(2): S1-11.

27. Kidd S.A., Eskanazi B., Wryobek A.J. Effects of male age on semen quality and fertility: a review of the literature. Fertil. Steril. 2001; 75(2): 237-48.

28. Rolf C., Behre H.M., Nieschlag E. Reproductive parameters of older compared to younger men of infertile couples. Int. J Androl. 1996; 19: 135-42.

29. Toriello H.V., Meck J.M. Statement on guidance for genetic counseling in advanced paternal age. Genet. Med. 2008; 10: 457-60.

30. Kovac J.R., Addai J., Smith R.P., Coward R.M., Lamb D.J., Lipshultz L.I. The effects of advanced paternal age on fertility. Asian J. Аndrol. 2013; 15(6): 723-8.

31. Wiener-Megnazi Z., Auslender R., Dirnfeld M. Advanced paternal age and reproductive outcome. Asian J. Androl. 2012; 14: 69-76.

32. Belloc S., Benkhalifa M., Cohen-Bacrie M., Dalleac A., Amar E., Zini A. Sperm deoxyribonucleic acid damage in normozoospermic men is related to age and sperm progressive motility. Fertil. Steril. 2014; 101(6): 1588-93.

33. Jaleel R., Khan A. Paternal factors in spontaneous first trimester miscarriage. Pak. J. Med. Sci. 2013; 29(3): 748-52.

34. Stern J.E., Luke B., Tobias M., Gopal D., Hornstein, M.D., Diop H. Adverse pregnancy and birth outcomes associated with underlying diagnosis with and without assisted reproductive technology treatment. Fertil. Steril. 2015; 103(6): 1438-45.

35. Sharma R., Biedenharn K.R., Fedor J.M., Agarwal A. Lifestyle factors and reproductive health: taking control of your fertility. Reprod. Biol. Endocrinol. 2013; 11: 66.

36. Dohle G.R., Diemer T., Givercman A., Jungwirth A., Kopa Z., Krausz C. Guidelines on male infertility. European Association of Urology; 2010.

37. Miyamoto T., Tsujimura A., Miyagawa Y., Koh E., Namiki M., Sengoku K. Male infertility and its causes in human. Adv. Urol. 2012; 2012: 384520.

38. Benchaib M., Braun V., Lornage J., Hadj S., Salle B., Lejeune H., Guérin J.F. Sperm DNA fragmentation decreases the pregnancy rate in an assisted reproductive technique. Hum. Reprod. 2003; 18(5): 1023-8.

39. Carrell D.T., Liu L., Peterson C.M., Jones K.P., Hatasaka H.H., Erickson L., Campbell B. Sperm DNA fragmentation is increased in couples with unexplained recurrent pregnancy loss. Arch. Androl. 2003; 49(1):49-55.

40. Findikli N., Kahraman S., Kumtepe Y., Donmez E., Benkhalifa M., Biricik A. et al. Assessment of DNA fragmentation and aneuploidy on poor quality human embryos. Reprod. Biomed. Online. 2004; 8(2): 196-206.

41. Seli E., Sakkas D. Spermatozoal nuclear determinants of reproductive outcome: implications for ART. Hum. Reprod. Update. 2005; 11(4): 337-49.

42. Worrilow K.C., Huynh H.T., Bowers J.B., Anderson A., Schillings W., Crain J. PICSI versus ICSI: Statistically significant improvement in clinical outcomes in 240 in vitro fertilization (IVF) patients. Fertil. Steril. 2007; 88(Suppl. 1): S37.

Received 21.12.2016

Accepted 23.12.2016

About the Authors

Dudarova Alina Khasanovna, Ph.D, graduate student of department of assisted reproductive technology in treating sterility, Research Center of Obstetrics,
Gynecology, and Perinatology, Ministry of Health of Russia. 117997, Russia, Moscow, Ac. Oparina str. 4. Tel.: +74954382501. E-mail: kanshaov85@mail.ru
Smolnikova Veronika Yurievna, M.D, Senior Researcher of the department of assisted reproductive technology in infertility treatment, Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health of Russia. 117997, Russia, Moscow, Ac. Oparina str. 4. Tel.: +74954381341. E-mail: v_smolnikova@ oparina4.ru
Makarova Natalia Petrovna, PhD., Researcher of the department of assisted reproductive technology in infertility treatment, Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health of Russia. 117997, Russia, Moscow, Ac. Oparina str. 4. Tel.: +74954381341. E-mail: np.makarova@gmail.com
Gorshinova Viсtoria Konstantinovna, MD, Researcher of the department of assisted reproductive technology in infertility treatment, Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health of Russia. 117997, Russia, Moscow, Ac. Oparina str. 4. Tel.: +74954382501. E-mail: chiasma@mail.ru
Kalinina Elena Anatolievna, MD, The chief of department of assisted reproductive technology in infertility treatment, Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health of Russia. 117997, Russia, Moscow, Ac. Oparina str. 4. Tel.: +74954381341. E-mail: e_kalinina@oparina4.ru
Popova Alina Yurievna, Ph.D, Senior Researcher of andrology and urology department, Research Center of Obstetrics, Gynecology, and Perinatology,
Ministry of Health of Russia. 117997, Russia, Moscow, Ac. Oparina str. 4. Tel.: +74954381341. E-mail: v_smolnikova@ oparina4.ru
Gamidov Safar Isreilovich, PhD, Leading Researcher of andrology and urology department, Research Center of Obstetrics, Gynecology, and Perinatology,
Ministry of Health of Russia. 117997, Russia, Moscow, Ac. Oparina str. 4. Tel.: +74954381341. E-mail: a_donnikov@oparina4.ru

For citations: Dudarova A.Kh., Smolnikova V.Yu., Makarova N.P., Gorshinova V.K., Popova A.Yu., Gamidov S.I., Kalinina E.A. Different oocyte fertilization methods and their relationship to the effectiveness of assisted reproductive technology programs in the treatment of infertility. Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2017; (7): 96-103. (in Russian)
http://dx.doi.org/10.18565/aig.2017.7.96-103

Similar Articles

By continuing to use our site, you consent to the processing of cookies that ensure the proper functioning of the site.