A comparison of three spermatozoa selection techniques for Intracytoplasmic Sperm Injection (ICSI) using swim-up, Cumulus Oophorus Model and PICSI ® Dish

Rijsdijk, Michelle (2015-12)

Thesis (PhD)--Stellenbosch University 2015.

Thesis

ENGLISH ABSTRACT: Introduction: Spermatozoa selection for Intracytoplasmic Sperm Injection (ICSI) is a paramount factor in the outcome of a fertility treatment cycle. Nature has perfected the selection process by using the cumulus matrix to select spermatozoa that are morphologically and genetically normal. Aim: To determine which method of semen preparation delivers the best results in terms of spermatozoa selection for ICSI. Methods: Patients were randomized into 3 groups of spermatozoa selection techniques namely the routine swim-up or density gradient, the Cumulus Model or the PICSI® dish (hyaluronic acid). The prepared collected spermatozoa were used to make slides to record the percentage of normal spermatozoa (morphological staining), the capacitational status (chlorotetracycline test), chromatin packaging quality (chromomycin A3 (CMA3) staining) and the DNA quality (acridine orange staining). These results were then compared to the fertilization, cleavage, pregnancy and implantation rates of the patients used in the study. Results: All three groups displayed improvements in morphology, capacitational ability, chromatin packaging quality and DNA quality (or fragmentation). There was no significant difference in pregnancy rates between the groups and no difference in implantation rates. The PICSI® group did however show a significant improvement in the chromatin packaging quality, only if the baseline values were low. Conclusions: All 3 groups of spermatozoa selection techniques showed improvements in spermatozoa quality. The swim-up/gradient group showed a statistical improvement in the fertilization rate when compared to the cumulus and PICSI® groups. PICSI® showed a greater improvement in selected spermatozoa parameters when baseline values for CMA3 were low.

AFRIKAANSE OPSOMMING: Inleiding: Die seleksie van spermatosoa vir Intrasitoplasmatiese Sperm Inspuiting (ICSI) is 'n deurslaggewende faktor in die uitkoms van 'n fertiliteitsbehandeling-siklus. Die natuurlike seleksieproses van morfologies en geneties normale sperme, word bepaal deur die cumulus oophorus matriks. Doel: Om die beste metode van semen voorbereiding te bepaal, waardeur optimale resultate in terme van seleksie van spermatosoë kan plaasvind vir ICSI. Metodes: Pasiënte is ewekansig in drie groepe van spermseleksie-tegnieke verdeel, naamlik die opswemtegniek, die Cumulus Model of die PICSI® Dish (Hialuroon suur). Die voorbereide spermatosoa is gebruik om mikroskoopskyfies te maak vir die bepaling van die persentasie, normale morfologiese spermatosoë, die kapasitasie status (Chlorotetrasikline toets), chromatien verpakking kwalitiet (Chromomycin A3 kleuring) en die DNA-integriteit (Akridien Oranje kleuring). Die resultate is vergelyk tov die bevrugting-, verdeling-, swangerskap- en inplantasie syfers van die pasiënte in die studie. Resultate: Al drie groepe het verbeterings getoon ten opsigte van morfologie, kapasitasie, chromatien verpakking kwaliteit en DNA fragmentasie. Daar was geen beduidende verskil in swangerskap of inplantasie syfers tussen die groepe nie. Die PICSI® groep het 'n statisties betekenisvolle verbetering getoon as die CMA3 waarde laag was voor die seleksie metode. Gevolgtrekkings: Al drie spermatosoë seleksie tegnieke het verbeterings getoon in spermatozoa kwaliteit. Die opswemtegniek-groep het 'n statistiese betekenisvolle verbetering in die bevrugtingsyfer getoon in vergelyking met die PICSI en cumulus metodes. Die PICSI® tegniek het ‘n betekenisvolle verbetering getoon as waardes vir CMA3 laag.

Please refer to this item in SUNScholar by using the following persistent URL: http://hdl.handle.net/10019.1/97886
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