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Semen parameters on the intracytoplasmic sperm injection day: Predictive values and cutoff thresholds of success

El din-Abdel Aal Moubasher Alaa, Taha Emad Abdelrehim, Elnashar Ehab Mohamed, Maged Ahmed Abdel Aal Abdel, Zahran Asmaa Mohamed, Sayed Heba Hassan, Gaber Hisham Diab,
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 ( El din-Abdel Aal Moubasher Alaa ) - Assiut University Faculty of Medicine Department of Dermatology, Venereology and Andrology
 ( Taha Emad Abdelrehim ) - Assiut University Faculty of Medicine Department of Dermatology, Venereology and Andrology
 ( Elnashar Ehab Mohamed ) - Assiut University Faculty of Medicine Department of Obstetrics and Gynecology
 ( Maged Ahmed Abdel Aal Abdel ) - Assiut University Faculty of Medicine Department of Dermatology, Venereology and Andrology
 ( Zahran Asmaa Mohamed ) - Assiut University South Egypt Cancer Institute Department of Clinical Pathology
 ( Sayed Heba Hassan ) - Assiut University Faculty of Medicine Department of Dermatology, Venereology and Andrology
 ( Gaber Hisham Diab ) - Assiut University Faculty of Medicine Department of Dermatology, Venereology and Andrology

Abstract


Objective: This study was conducted to investigate the relationship of semen parameters in samples used for intracytoplasmic sperm injection (ICSI) with fertilization and pregnancy rates in infertile couples.

Methods: In this prospective study of Infertile couples with male factor infertility that had undergone ICSI, fractions of the same semen samples obtained for microinjection (to ensure the best predictability) were evaluated to determine the semen parameters and sperm DNA fragmentation index (DFI) on the day of oocyte recovery.

Results: In total, 120 couples completed the study and were subdivided into fertilized (n=87) and non-fertilized couples (n=33). The fertilized couples were further classified into pregnant (n=48) and non-pregnant (n=39) couples. Compared to non-fertilized and non-pregnant couples, fertilized and pregnant couples showed statistically significantly higher sperm viability and percentage of normal sperm morphology, as well as significantly lower sperm DFI values. A receiver operating characteristic curve analysis of data from the 120 ICSI cycles showed that sperm viability, normal sperm morphology percentages, and sperm DFI were significant prognostic indicators of fertilization at cutoff values of 40%, 7%, and 46%, respectively. A sperm DFI of 46% showed sensitivity and specificity of 95% and 90%, respectively, for predicting fertilization, and no clinical pregnancies occurred in couples with a sperm DFI above 46%.

Conclusion: Semen parameters from the ICSI day sample, especially sperm viability, normal morphology, and DFI, had an impact on fertilization and pregnancy outcomes in ICSI cycles.

키워드

Intracytoplasmic sperm injection; Fertilization; Pregnancy rate; Semen; Sperm DNA fragmentation index

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