Cover
Vol. 6 No. 1 (2016)

Published: June 30, 2016

Pages: 61-71

Research Article

Embryo Grading and Pregnancy Outcome in Women of Patients with Azoospermia Following ICSI

Abstract

Background: Azoospermia is defined as the lack of sperm in male ejaculate and is suggested to be present in about 1 % of all males and to account for 10-15% of the causes of infertility in men. The development of intracytoplasmic sperm injection (ICSI) as an effective therapy. Embryo grading has gained special attention in published literature regarding its predictive role in pregnancy outcome following ICSI; however, substantial controversy is present that justified the carrying out of the present study. Objective: To study the association between embryo quality and pregnancy rate in women of males with azoospermia. Patients,Materials and Methods: This prospective cohort study included 60 patients with azoospermia, 15 male with obstructive type and 45 males with non-obstructive type.Those patients were randomly selected form the population of infertile couples who regularly visits the High Institute for Infertility Diagnosis and Assisted Reproductive Technologies and from Kamal Al-Samarrai Hospital -Center for Infertility Treatment and IVF. Results Pregnancy was encountered in 7 patients (23.33%). It was not statistically associated with type of azoospermia (P=0.388), also it was not affected by age and serum hormonal level, but highly determined by good quality of embryo. Quality of embryo was graded from 1 to 4. The lower the grade, the better the quality of the embryo was. Quality of embryo was not significantly correlated with type of azoospermia, age and hormonal levels. Conclusions Good quality of embryo is a significant predictor of positive pregnancy outcome in ICSI and the quality of embryo is not affected by age of male patient or type of azoospermia.

References

  1. Cocuzza M, Alvarenga C, Pagani R. The epidemiology and etiology of azoospermia. Clinics. 2013; 68 (1):15-26.
  2. Foghi K, Ghaffari Novin M, Madjd Jabbari Z, Najafi T, Heidari MH, Rostampour Yasoori A. Immuno- histochemical localization of endothelial nitric oxide synthase in testicular cells of men with non- obstructive azoospermia. Iranian Journal of Reproductive Medicine. 2011; 9(4):277-280.
  3. Kumar R. Medical management of non-obstructive azoospermia. Clinics. 2013; 68(1): 75-79.
  4. Pandurangi M, Tamizharasi M, Reddy NS. Pregnancy outcome of assisted reproductive technology cycle in patients with hypogonadotropic hypogonadism. Journal of Human Reproductive Sciences. 2015;8(3):146-150.
  5. Simon L., Murphy K., Shamsi M.B., Liu L., Emery B., Aston K.I., Hotaling J., Carrell D.T. Paternal influence of sperm DNA integrity on early embryonic development. Hum. Reprod. 2014; 29: 2402–2412.
  6. Moein, M. R., Moein, M. R., Ghasemzadeh, J., & Pourmasoumi, S. Evaluation of sperm retrieval rate with bilateral testicular sperm extraction in infertile patients with azoospermia. Iranian Journal of Reproductive Medicine. 2015; 13(11), 711–714.
  7. Omurtag K, Cooper A, Bullock A, Naughton C, Ratts V, Odem R, et al. Sperm Recovery and IVF after Testicular Sperm Extraction (TESE): Effect of Male Diagnosis and Use of Off-Site Surgical Centers on Sperm Recovery and IVF. PLoS ONE. 2013; 8(7): e69838.
  8. Kalsi, J. S., Shah, P., Thum, Y., Muneer, A., Ralph, D. J. and Minhas, S. Salvage micro-dissection testicular sperm extraction; outcome in men with non-obstructive azoospermia with previous failed sperm retrievals. BJU Int. 2015; 116: 460–465.
  9. Modarresi, T., Hosseinifar, H., Daliri Hampa, A., Chehrazi, M., Hosseini, J., Farrahi, F., Sadighi Gilani, M. A. Predictive Factors of Successful Microdissection Testicular Sperm Extraction in Patients with Presumed Sertoli Cell-Only Syndrome. International Journal of 70 Fertility and Sterility. 2015; 9(1): 107–112.
  10. Demir B, Arikan II, Bozdag G, Esinler I, Karakoc Sokmensuer L, Gunalp S. ICSI outcome of patients with severe oligospermia vs. non- obstructive azoospermia. Clin Exp Obstet Gynecol.2012; 39 (2):141– 143.
  11. Bocca, S., Moussavi, V., Brugh, V., Morshedi, M., Stadtmauer, L. and Oehninger, S. ICSI outcomes in men undergoing TESE for azoospermia and impact of maternal age. Andrologia.2016; doi:10.1111/and.12617.
  12. Ren H, Ferguson K, Kirkpatrick G, Vinning T, Chow V, Ma S. Altered Crossover Distribution and Frequency in Spermatocytes of Infertile Men with Azoospermia. PLoS ONE 2016; 11(6): e0156817.
  13. Merchant R., Gandhi G., and Allahbadia G. N. In vitro fertilization/intracytoplasmic sperm injection for male infertility. Indian J Urol. 2011;27(1): 121–132.
  14. Tehraninejad, E. S. T., Pourmatroud, E., Sadighi Gilani, M. A., Rakebi, M., Azimi Neko, Z. and Arabipoor, A. Comparison of Intracytoplasmic Sperm Injection Outcomes between Oligozoospermic, Obstructive Azoospermic and Non- Obstructive Azoospermic Patients. 71 International Journal of Fertility and Sterility.2012; 6(1): 13–18.
  15. Kalsi J, Thum MY, Muneer A, Pryor J, Abdullah H, Minhas S. Analysis of the outcome of intracytoplasmic sperm injection using fresh or frozen sperm. BJU Int. 2011; 107:1124–1128.
  16. Tsai Y., Huang F., Lin P., Kung F., Lin Y., Lan K. Clinical outcomes and development of children born to couples with obstructive and nonobstructive azoospermia undergoing testicular sperm extraction-intracytoplasmic sperm injection: A comparative study. Taiwanese Journal of Obstetrics and Gynecology. 2015; 54 (2): 155 – 159.