Sperm preparation for intracytoplasmic injection: methods and relationship to fertilization results.

Sperm preparation for intracytoplasmic sperm injection (ICSI) is described and the effect of high speed centrifugation during preparation on fertilization rate is evaluated. No significant differences were found in the 2-pronuclear or abnormal fertilization rates between sibling oocytes injected with sperm prepared by swim-up or mini-Percoll combined with high speed centrifugation. The high fertilization rate obtained with both methods indicates that high speed centrifugation is not necessary to prepare sperm for ICSI. Fertilization rates were also compared for sperm obtained from ejaculates, fresh and frozen epididymal aspirates, and testicular biopsies. High fertilization rates were obtained from all groups but they were significantly higher in those oocytes injected with epididymal sperm (78% per oocyte surviving injection). The high fertilization rate with epididymal sperm may reflect sperm quality or may result from the method of sperm preparation for injection. Fertilization after the injection of sperm from which the tail was dislodged during immobilization was compared with that obtained using intact sperm. A significantly lower rate of 2-pronuclear fertilization was found in those oocytes injected with sperm heads only (55%) compared with intact sperm (68%), although cleavage rates between the two groups were similar. The use of hypo-osmotic medium to select potentially live sperm from an immotile sample is also described and fertilization was obtained after the injection of sperm with a structural defect which were selected using this technique. These results indicate that high fertilization rates can be obtained with ejaculated, epididymal and testicular sperm without special treatment.(ABSTRACT TRUNCATED AT 250 WORDS)