COMPARATIVE ANALYSIS OF SPERM SELECTION METHODS BEFORE THE INTRA CYTOPLASMIC SPERM INJECTION PROCEDURE.

In recent years, one of the methods of assisted reproductive technologies has become increasingly widespread, namely the ICSI procedure (ICSI - Intra Cytoplasmic Sperm Injection). This method is based on artificial introduction of the spermatozoon into the cytoplasm of the oocyte. However, the complexity of this method is that the choice of a morphologically and biochemically mature spermatozoon becomes subjective. However, not so long ago, an innovative method for selecting mature, ready-to-fertilize spermatozoa was proposed. This method was called PICSI (PICSI - Physiologic Intra Cytoplasmic Sperm Injection). It is based on the ability of mature spermatozoa to bind to hyaluronic acid. Currently, there are two methods for selection of mature spermatozoa with hyaluronic acid: polystyrene culture cups the inner surface of which are coated with microcap lagialuronate (PICSI Sperm Selection Device; Mid Atlantic Diagnostic - Origio) and a liquid medium containing hyaluronic acid (Sperm Slow; Medi Cult - Origio). We selected 60 family couples with a history of one or more unsuccessful attempts at in vitro fertilization or early reproductive loss in an anamnesis after infertility treatment. The potential impact of an abnormal parental genome on the reproductive outcome of extracorporeal fertilization cycles has not yet been fully understood. However, in the last ten years, the quality of sperm DNA is considered one of the possible reasons for the poor quality of the embryos, especially after the ICSI procedure. Sperm selection, based only on microscopic analysis, can lead to inadequate evaluation and selection of spermatozoa with chromosomal or cytoplasmic abnormalities in a visually morphologically normal cell. Studies have shown that this method of selection of mature spermatozoa, such as PICSI, is a very effective addition to the ICSI procedure in couples with predominance of the male factor of infertility. A possible reason for the effectiveness of this method is a more physiological selection of mature spermatozoa and, as a consequence, a decrease in the number of participating in the cycles of IVF spermatozoa with an anomalous genome. The use of both PICSI cups and media containing hyaluronic acid in the liquid form of SpermSlow for the selection of mature spermatozoa is equally ffective.