Effect of sperm selection methods on ICSI outcomes in patients with oligoteratzoospermia.

OBJECTIVE

Sperm selection without - or with a low level of - protamine deficiency and DNA fragmentation is a remarkable indicator to increase the success rate of ICSI outcomes. The aim of this study was to compare sperm selection methods in the elimination of sperm with protamine deficiency and DNA fragmentation and their effects on ICSI Outcomes in oligoteratzoospermia patients.

METHODS

Semen samples were obtained from oligoteratozoospermia patients undergoing ICSI. Sperm selection was conducted using Zona Pellucida (ZP) binding, Hyaluronic Acid (HA) binding, and conventional PVP methods. SCD assay and CMA3 staining were used for the detection of sperm protamine deficiency and DNA fragmentation. Good quality of the embryo, blastocyst formation, chemical, and clinical pregnancy rates among studied groups was evaluated and compared.

RESULTS

Our results indicated the percentage of sperm DNA fragmentation and protamine deficiency were lower significantly in the HA- and ZP-bound sperm. Although no significant differences were observed in the fertilization rate among studied methods, good quality of cleavage embryo rates were increased using ZP and HA methods versus the conventional PVP method. However, there were no significant differences in cleavage and embryo quality between the HA compared to the ZP method. Blastocyst formation, chemical and clinical pregnancy rates increased in the HA method.

CONCLUSIONS

Overall, the HA method for sperm selection due to high sensitivity in selecting sperm with a low level of DNA fragmentation and protamine deficiency is a very useful method to increase the success rate of ICSI outcomes in oligoteratozoospermia patients.