جستجوی مقالات مرتبط با کلیدواژه « Intracytoplasmic sperm injection » در نشریات گروه « پزشکی »

Endometriosis is a chronic inflammatory condition affecting 6 to 10% of the women at reproductive age. The clinical manifestations of this condition differ according to its location.

In this study, the case of a 30-year-old infertile woman presented with a history of abdominal pain and three times cleavage formation arrests after Intracytoplasmic sperm injection (ICSI) was reported. Ethanol sclerotherapy (EST) was selected due to abdominal pain and previous in vitro fertilization (IVF) cycles, and ovarian stimulation was initiated eight weeks later. The patient was stimulated in a minimal stimulation protocol. A total of six oocytes were retrieved, resulting in 3 embryos of good to moderate quality that were frozen. The patient became pregnant following two embryo transfers in the FET cycle.

EST may have been considered as a first-line therapy to treat infertility after the failure of IVF. It was found that EST may have improved IVF outcomes.

To evaluate the associations between serum and follicular zinc levels and the response to intracytoplasmic sperm injection (ICSI). Patients and

A prospective cohort study was conducted between May 2022 and May 2023 on 120 infertile women randomly selected based on specific criteria. The patients were classified into three groups according to stimulation response. Serum zinc level was measured in all patients on the day of ovarian stimulation, and follicular fluid zinc level was measured at the time of pickup. We monitored the patients to evaluate the correlation between serum and follicular zinc levels, as well as the reaction to ovarian stimulation. We assessed oocyte quality and quantity, fertilization rate, embryo quality, and clinical pregnancy rate.

The participants were homogenized at comparable ages. The 120 patients were classified into three groups according to the number of oocytes retrieved after ovum pick-up: four oocytes were categorized as poor responders (n = 40), 4-15 retrieved oocytes were categorized as normal responders (n = 40), and >15 retrieved oocytes were categorized as hyper-responders (n = 40). The poor responders had significantly lower serum and follicular zinc levels than the others. There was a significant difference between the three groups (P value = 0.0001). There was a direct positive correlation between serum and follicular zinc levels. However, there was a moderately negative correlation between the serum and follicular zinc levels and the total gonadotropin dose. On the other hand, there was a slightly positive link between the amount of zinc in the serum and follicles and the response to stimulation in the ICSI cycle in terms of the number of oocytes, ovarian sensitivity index (OSI), follicular output rate (FORT), and follicle-to-oocyte index (FOI). There was a strong positive correlation between serum and follicular zinc levels and the fertilization rate and number of MII but a weak positive correlation with the number of MI. All significant correlations between serum and follicular zinc levels were found to be predictors of clinical pregnancy.

The serum zinc level at stimulation day was reflected in the follicular fluid zinc levels after stimulation and at the time of ovum pick-up. Both of them predict the success of an ICSI cycle, including the response to stimulation and the pregnancy rate. The serum zinc level can also indicate cases that may progress to clinical pregnancy. It is crucial to measure the blood zinc levels of women preparing to undergo ICSI. The start of ICSI program should be delayed until the serum zinc level is optimal, as it is a predictor of the response to stimulation and the outcome of the ICSI cycle. Encouraging adequate zinc intake prevents the potential impact of altered zinc levels on the success rate of these women’s responses to stimulation.

Middle-aged working women represent most patients attending fertility clinics for in vitro fertilization (IVF) treatment. In this study, we aimed to identify the association of women’s working status with clinical pregnancy and miscarriage in the first trimester after IVF treatment.

In this single-centre cross-sectional study at a private clinic in Kazakhstan, we reviewed electronic medical records of all IVF with intracytoplasmic sperm injection (ICSI) and fresh embryo transfer (ET) cycles from January 2018 to December 2019 (n=654). 300 cycles in patients with normal ovarian reserve and registered working status of a female partner in the medical records were selected for the analysis. The study's primary outcome measures were clinical pregnancy rates and clinical miscarriage in the first trimester.

204 women were employed, while 96 were not employed before the start of treatment. The mean age of all patients was 32.2 ± 4.8 years, ranging from 23 to 46 years. Two-thirds of working women had office-based occupations employed as doctors, school and university teachers, accountants, clerks, and managers. One-third of the study participants had manual labor jobs, including service positions and plant workers. There was no association between women’s working status and clinical pregnancy rate adjusted for age, antral follicle count, history of pelvic adhesiolysis, and embryo development stage at embryo transfer. However, working women had almost five times the risk of the first trimester miscarriage compared to non-working women [adjusted odds ratio (aOR) 4.56, 95% confidence interval (CI): 0.52 to 4.96] adjusted for age and number of retrieved oocytes.

Women who work before commencing IVF treatment can be reassured of having equal chances of conception following the treatment compared to non-working women. The observed risk of first trimester miscarriage in working women necessitates further research before drawing any conclusions from medical and public health points.

Background &  The presence of anesthetic drugs in the serum with possible negative effects on FSH and LH hormone concentration and vital signs has been shown in a number of experimental and human research.To measure the effects on blood hormone concentration and the effect on the vital signs (blood pressure and heart rate) of two different medications (remifentanil vs. fentanyl) used for general anesthesia during oocyte retrieval.Materials &  The present prospective comparative study was carried out at Iraq's "High Institute of Infertility Diagnosis and Assisted Reproductive Technologies/Reproductive Physiology/Al-Nahrain University/Baghdad/Iraq" infertility center with the approval of the Faculty of Science's ethical committee. Mansoura University approved the study's validity. Ninety infertile women who are undergoing intracytoplasmic sperm injections (ICSI) for a variety of infertility-related reasons. The women ranged in age from 25 to 45. The study's original December 2022 deadline was pushed out to December 2023. Patients were split into two groups based on the general anesthesia technique for oocyte retrieval. Group one (45 patients) received midazolam, propofol, and fentanyl; group two (45 patients) received remifentanil, midazolam, and propofol. We compared the FSH and LH hormone levels before and after anesthesia and also compared the effect of anesthesia on vital signs between two groups of patients before and after anesthesia; accordingly, there was significantly higher systolic blood pressure in remifentanil group (p=0.30); however, there were no significant differences in diastolic blood pressure (p=0.767) and heart rates (p=0.512). The associations of LH and FSH with anesthesia are different depending on the type of anesthetic drugs.

The recognized role of Anti-Müllerian hormone (AMH) as a marker for women's biological age and ovarian reserve prompts debate on its efficacy in predicting oocyte quality during IVF/ICSI. Recent findings challenging this view compelled us to conduct this study to examine the correlation between AMH levels and quantity/quality of oocytes in IVF/ICSI procedures.

The data were collected retrospectively from the medical records of 320 women between 25-42 years old. The included patients were divided into two groups: the high AMH group (>1.1 ng/ml) and the low AMH (=<1.1 ng/ml) group. The high AMH group comprised 213 patients, while the low AMH group consisted of 107 patients. Spearman's correlation coefficient and Multinomial logistic regression were computed to assess the relationships between different variables.

Significant positive correlations were detected between AMH level and the number of aspirated follicles (rho=0.741, p<0.001), retrieved oocytes (rho=0.659, p< 0.001), M2 oocytes (rho=0.624, p<0.001), grade A embryos (rho=0.419, p<0.001), and grade AB embryos (rho=0.446, p<0.001. In contrast, AMH levels had negative associations with the number and duration of cycles (p<0.05). AMH emerged as a statistically significant independent predictor of the number of M2 oocytes.

Serum AMH level could represent the quantity and quality of oocytes following IVF/ICSI treatments. Future studies should aim to delve deeper into the correlations between AMH levels and both the quality and quantity of embryos. Additionally, it would be beneficial to consider the influence of sperm factors, as well as assess pregnancy rates.

Phospholipase C zeta (PLC-ζ) deficiency in sperm can underlie oocyte activation failure after intracytoplasmicsperm injection (ICSI). The aim of this study was to determine PLC-ζ expression and location in individualspermatozoa in each host score so that a hypo-osmotic swelling test (HOST) may be used to help routine sperm selectionfor ICSI. In this experimental study, fresh semen samples were randomly obtained from 30 men whowere referred to the Andrology Unit of the Infertility Center. Samples were processed by density gradient centrifugation(DGC) and exposed to hypotonic conditions. Seven different tail patterns, classified from ‘a’ to ‘g’ can be detectedaccording to World Health Organization (WHO) criteria. Then, the PLC-ζ protein localization pattern was assessed byquantitative Immunofluorescence in individual sperm Host grades. Moreover, the sperm content of PLC-ζ protein wasevaluated by flow cytometry correlated with semen analysis parameters. In the present study, quantitive immunofluorescence analysis indicated that sperm from different host gradesexhibited seven localization patterns of PLC-ζ of acrosomal (A); equatorial (EQ), and postacrosomal (PA) patterns.A+EQ=acrosomal and equatorial, A+PA=acrosomal and post-acrosomal, EQ+PA=equatorial and post-crosomal, andA+EQ+PA.The sperm from HOST grade 'd' exhibited significantly higher PLC-ζ (A+PA) and (A+EQ+PA) staining compared to spermfrom other grades (P=0.006). The sperm from grade 'd' exhibited higher PLC-ζ (EQ+PA) compared with other grades(P=0.001). However, grade 'd' was not significantly different from 'c' (P=0.087). Analysis of the combined results confirmedthat there was a clear reduction in PLC-ζ immunofluorescence in Host grades 'a', 'f' and 'g' sperms. Our data suggest that HOST may represent a useful diagnostic tool for the selection of sperms exhibitinga higher level of PLC-ζ expression.

 Phenotypic dysmorphism is not rare to be found in the human oocyte, especially in the perivitelline space, which are among the most important aberration of the extra cytoplasmic component.

 The case is of a 30-yr-old woman with no previous pregnancy, attempting an in vitro fertilization treatment for the first time. Given the extraordinary quantity of granular particles found in the perivitelline space, visible after the stripping procedure, it was not possible to establish the presence and position of the first polar body to appreciate the correct oocyte maturation (metaphase 2). Nevertheless, all the eggs were injected by the intracytoplasmic sperm injection. A time lapse incubator was used to perform the entire culture. Hence, a record of 6 days culture video was obtained. Only 2 eggs could fertilize correctly and reach the blastocyst stage on day 6. The embryos were frozen and subsequently transferred as frozen embryo transfer following the next menstrual cycle.

 The exceptional presence of granular particles in the perivitelline space, which reminds us for aspects and behavior the granulosa cells, seems to affected the fertilization but not the blastocysts quality. As a matter of fact the woman, after the embryo transfer, achieved a successful twin live birth.

The intracytoplasmic sperm injection (ICSI) has significantly improved male factor infertility treatment; however, complete fertilization failure still occurs in 1-5% of ICSI treatment cycles mainly due to oocyte activation failure. It is estimated that around 40-70% of oocyte activation failure is associated with sperm factors after ICSI. Assisted oocyte activation (AOA) as an effective approach to avoid total fertilization failure (TFF) has been proposed following ICSI. In the literature, several procedures have been described to overcome failed oocyte activation. These include mechanical, electrical, or chemical stimuli initiating artificial Ca2+ rises in the cytoplasm of oocytes. AOA in couples with previous failed fertilization and those with globozoospermia has resulted in varying degrees of success. The aim of this review is to examine the available literature on AOA in teratozoospermic men undergoing ICSI-AOA and determine whether the ICSI-AOA should be considered as an adjunct fertility procedure for these patients.

As the world's population increases, the incidence of infertility is increasing, and infertility is now considered to affect 8–12% of couples worldwide. Assisted reproductive technology (ART) such as in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI) is revolutionizing the field of reproductive medicine and strives continuously to provide infertile patients with access to appropriate and efficient treatments. However, some causes leading to total/low fertilization rate in ART have been addressed. Phospholipase C zeta (PLCζ) is the main sperm-specific factor responsible for triggering oocyte activation (OA). Therefore, PLCζ abnormalities, including low and absent expression as well as its mutation has been described as one of the fertility rate inducers resulted from the oocyte activation deficiency and sperm parameters abnormalities and failed IVF and ICSI cycles. In this review article we have aimed to focus on the latest information of the PLCζ published data in the Web of Science, Scopus, Science Direct and PubMed databases and resulted in the failed IVF and ICSI and recurrent ICSI and IVF failure. In addition the investigations on PLCζ gene and its coded protein in the animals have been also reported.

Studies have shown that the change in PLCζ expression and its mutations can cause a decrease in the fertilization rate due to egg activation defects and abnormalities in sperm parameters and failure in ART.

Gestational trophoblastic disease (GTD) is a heterogeneous group of diseases characterized by excessive proliferating trophoblastic tissue. The prevalence of GTD has a varied geographical distribution. However, its frequency following intracytoplasmic sperm injection (ICSI) cycles has not yet been reported. This study aimed to estimate GTD frequency and prevalence after ICSI cycles. This retrospective cross-sectional study included all patients diagnosed with GTD subsequent to ICSI and segmental embryo transfer procedure during 2011-2019 at Royan Institute. GTD diagnosis was established for patients who met all three criteria: beta-human chorionic gonadotropin (β-hCG) levels greater than 100,000 mIU/mL, vesicular ultrasonographic pattern, and presence of pathologic features of hydatidiform mole. Although we assessed the GTD frequency in all ICSI cycles, GTD cases were only observed following fresh embryo transfer ICSI procedures. We evaluated 25,667 fresh embryo transfer ICSI procedures out of 41,540 ICSI cycles. This study identified a total of 10 GTDs confirmed by all criteria which were mentioned previously. Of these 10 GTDs, nine cases had hydatidiform mole, and one had gestational trophoblastic neoplasia. The frequency of GTD was calculated 10 cases in 41,540 (0.240 per 1000) ICSI procedures and 10 in 25,667 (0.389 per 1000) fresh embryo transfers following ICSI cycles. Also, we detected 10 GTD cases in 8,196 (1.220 per 1000) clinical pregnancies. We discuss that the possibility of GTD after ICSI procedure is not as low as expected. Thus, the previous theses are insufficient to explain all aspects of molar pregnancy, and more research is required.

Autologous platelet-rich plasma consists of concentrated autologous plasma and several cytokines and growth factors released by activated platelets in injury and inflammation. There is an increasing trend towards the effectiveness of intrauterine PRP infusion in repeated implantation failure patients. The aim of the present study was to describe the impact of intrauterine platelet-rich plasma infusion on the live birth rate in patients with repeated implantation failure.

The present retrospective uncontrolled study was performed on 96 patients with more than two failed intracytoplasmic sperm injection cycles at Mehr medical institute between 2019 and 2021. Forty-eight hours before embryo transfer, patients received 1 mL lympho-platelet-rich plasma through an intrauterine insemination catheter. Patients were evaluated for pregnancy rate. Endometrial preparation for frozen-thawed embryo transfer was performed.

Participants' basal and stimulation characteristics, including gonadotropin dosage, the total number of oocytes, metaphase II oocytes and embryos, endometrial thickness, embryo transfer, quality of transferred embryos, and blastocyst transfer rate were evaluated. A total of 33 and 27 chemical (34.3%) and clinical pregnancies (28.1%) were achieved. Twenty (20.8%) and nineteen (20%) cycles resulted in ongoing pregnancies or live births, respectively.

The current study suggests that platelet-rich plasma infusion 48 hours before frozen-thawed embryo transfer may be a good option for repeated implantation failure patients and results in 20% live birth.

The objective of this study was to evaluate treatment outcomes and assess predictors of clinical pregnancy in obstructive azoospermia cases treated with testicular sperm extraction (TESE) and intracytoplasmic sperm injection (ICSI) in Ghana.

This study was a retrospective study conducted on 67 men seeking treatment for obstructive azoospermia at two study sites in Ghana from January 2018 to December 2019. First, archived data were reviewed and treatment outcomes of cases of obstructive azoospermia from the hospital records were evaluated. Infertile men who met the inclusion criteria were recruited. Descriptive data were expressed in the form of frequencies and percentages. The dependent and independent variables were analyzed using multiple logistic regression and reported as odds ratios (ORs). The confidence interval (CI) was set at 95% and a p-value <0.05 was considered significant.

The mean age of male participants was 42.43±9.11 years (mean±SD) while the mean age of their partners was 32.89±5.73 years (mean±SD). The average duration of infertility before intervention was 5.01±3.60 years (mean±SD). Successful pregnancy was observed in 52.2% (35/67) of the participants. After adjusting for confounders, the rate of a successful clinical pregnancy was 0.07 lower for every additional year increase in the male’s age [AOR=0.93 (95%CI=0.87-0.99), p=0.02].

Overall the rate of clinical pregnancy following TESE/ICSI from our study was 52.2%. A man’s age was a strong predictor of successful clinical pregnancy among couples treated with TESE-ICSI for obstructive azoospermia in Ghana.

Myo-inositol is an intracellular mediator which is involved in various aspects of reproduction in women.

This study aimed to evaluate the impact of Myo-inositol on the outcomes of in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI) cycles in infertile women.

This double-blind randomized controlled trial was conducted on 70 infertile women referred to the Infertility Treatment Center, Besat hospital, Sanandaj, Iran from May 2019 to September 2019 for IVF/ICSI cycles. The participants were randomly divided into 2 intervention (n = 36) and control (n = 34) groups. The intervention group received 2000 mg of Myo-inositol and 200 mcg folic acid twice a day for 2 months and the control group received 200 mcg of folic acid twice a day for 2 months in the IVF/ICSI cycles (from the third day of cycle until the end of the second month). Finally, the number of oocytes, the quality of embryos, and the IVF/ICSI outcomes were compared between the 2 groups.

The mean numbers of oocytes, MII oocytes, and 2 pronuclear embryos were significantly higher in the intervention group than the control group. Also, the clinical pregnancy and live birth rates in the intervention group were significantly higher than in the controls (p = 0.04).

The administration of Myo-inositol may increase clinical pregnancy and live birth rates by increasing the number of total and meiosis II oocytes in infertile women undergoing IVF/ICSI.

Declining fertility in a woman of advanced age is associated with a depletion in ovarian reserve as well as declining oocyte and embryo quality. Determining the predictors of embryo quality may assist in stimulation target and cycle prediction. 

This study aims to identify factors affecting embryo quality among women of advanced age receiving intracytoplasmic sperm injection (ICSI) cycles.

This prospective cohort study was conducted over a period of 12 months, from January until December 2018, on 734 mature oocytes retrieved from 124 women of advanced age (35-45 yr old) receiving ICSI. The Society of Assisted Reproductive Techniques system was used to determine the morphological grading of embryo quality. The fertilization rate, cleavage rate, and pregnancy rate per cycle were expressed as a percentage per cycle for a total of 76 embryo transfers. Possible predictors of high-quality embryos were evaluated using single and multiple regression tests, with p < 0.05 considered as significant.

Out of the 586 available embryos, 288 (49.15%) high-quality embryos were obtained. The fertilization and cleavage rates were 86.18% and 97.83%, respectively. The total number of retrieved oocytes (R2 = 0.857) and the total available embryos (R2 = 0.857) were closely related to high-quality embryos. 76 embryo transfers were conducted, with 17 successful conceptions (implantation rate = 22.37% per transfer). There were no miscarriages among the pregnancies.

  Increasing the number of collected oocytes and the cleavage rate could increase the chance of obtaining more high-grade embryos. This could increase the success of ICSI among women of advanced age.

Total fertilization failure (TFF) is associated with essential mechanistic and cellular events.

The present study is a comprehensive examination of detrimental effects with well-known assays for predicting TFF in conventional in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI) cycles.

Semen parameters of 90 men, including 60 cases who had experienced IVF/ICSI failure and a control group of 30 individuals, were evaluated. Sperm chromatin/DNA quality assessments were done by aniline blue, toluidine blue, chromomycin A3, and terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling (TUNEL) assays. A lipid hydroperoxide (LPO) kit was used to measure the LPO, and JC1 staining was used to evaluate mitochondrial membrane potential (MMP).

There were statistically significant differences found between the IVF, ICSI and control groups by the toluidine blue (p = 0.01), TUNEL (p = 0.02), and chromomycin A3 (p < 0.001) tests, but not by the aniline blue staining. Furthermore, there was a significant difference regarding LPO concentration and high MMP in cases of IVF fertilization failure compared to the control group (p = 0.04, p = 0.02, respectively). The logistic regression model showed that sperm viability was predictive for fertilization failure in the ICSI group. Sperm chromatin and DNA quality assays were not predictors for TFF in either group.

Cellular events such as high DNA fragmentation damage, high levels of reactive oxygen species, and low MMP levels can cause TFF in IVF and ICSI programs. Diagnostic tests, especially in cases with previous fertilization failure, showed significant differences in sperm chromatin and DNA quality between groups but could not predict the risk of TFF.

The aim of our study was to detect the rate of unexplained total fertilization failure (TFF) after intracytoplasmic sperm injection (ICSI) and identify its risk factors and retreatment prognosis. In this retrospective case-control study, we searched the computerized database ofthe Royan Institute (Tehran, Iran) from March 2015 to March 2019 and retrieved all cases diagnosed withTFF after ICSI. TFF cases that did not have any recognized risk factors were classified as unexplained (subgroupA). Cases with recognized risk factors were classified as subgroup B. The control group was randomlyselected from infertile couples who underwent ICSI cycles with fertilization of at least one oocyte during thesame time interval. Characteristics and treatment outcomes of the cases with unexplained TFF (subgroup A)were compared to the control group, and to the other TFF cases (subgroup B). Out of 18,750 couples who underwent ICSI cycles, 296 (1.58%) experienced TFF for the first time.Of these, 49 (16.5%) couples were diagnosed as unexplained TFF (subgroup A) and 247 (83.5%) were placedin subgroup B, TFF with expected risk factors. Multivariable logistic regression analysis showed that the totalnumber of mature oocytes (P<0.001), duration of infertility (P=0.043), and women’s body mass index (BMI,P<0.001) were significant predictive factors for unexplained TFF. In the ICSI cycle after TFF, clinical pregnancyand live birth rates in subgroup A were higher than subgroup B. Although differences between thesegroups were not statistically significant (P=0.14 and P=0.07, respectively), this finding could be clinicallyimportant. Unexplained TFF following ICSI is a rare event significantly related to a lower number of matureoocytes, longer duration of infertility and higher female BMI. It has a good prognosis in retreatment cycles incomparison with expected TFF cases. Clinicians should take this into consideration for patient counseling andmanagement.

Implementation of sperm preparation techniques based on cellular and molecular characteristics can improve the clinical outcomes of couples with male factor infertility. These methods attempt to select better sperm compared to classical methods of preparation such as swim-up and density gradient centrifugation (DGC). In this view, the aim of this study was the comparison of clinical outcomes of magnetic-activated cell separation (MACS) followed by DGC or DGC alone in infertile men undergoing intracytoplasmic sperm injection (ICSI). For this prospective single parallel blind clinical trial study, 206 infertile couples with male factor infertility and having abnormal sperm morphology higher than 96% were included. 106 and 100 couples were considered for the study (MACS-DGC) and control group (DGC), respectively. Clinical outcomes of ICSI; fertilization, embryo quality, and implantation, pregnancy rates were compared between two groups. Mean of fertilization (80.19 ± 1.88 vs. 75.63 ± 2.06, P=0.1), top embryo quality on the day 3 (30.22 ± 3.59 vs. 17.96 ± 2.9, P=0.009), clinical pregnancy (30.76% vs. 22.22%, P=0.19), and implantation rate (18.12% vs. 10.42%, P=0.04) were higher in the study group compared to the control group. Sperm preparation by MACS followed by DGC in teratozoospermic men could improve the clinical outcomes after ICSI (Registration number: IRCT201610317223N8).