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HB-Sperm Injections Associated With Higher Clinical Pregnancy Rates Than Standard Intracytoplasmic Sperm: Presented at ASRM

By Deborah Brauser

ATLANTA -- October 25, 2009 -- In vivo fertilisation (IVF) injection with hyaluronan-bound (HB) sperm selected using a sperm selection device (SSD) can lead to a higher clinical pregnancy rate than the standard intracytoplasmic sperm injection (ICSI), especially for patients with abnormal high-binding assay (HBA) scores, according to interim results from an ongoing multicentre study presented here at the 65th Annual Meeting of the American Society for Reproductive Medicine (ASRM).

A multi-site clinical trial evaluating PICSI® versus intracytoplasmic sperm injection (ICSI): positive clinical outcomes observed in a prospective, randomized and double-blinded study

K.C. Worrilow, S. Eid, J.M. Matthews, E.J. Pelts, C. Khoury, J. Liebermann
O-123 Tuesday, October 20, 2009 5:30 PM

Article Outline

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OBJECTIVE: Hyaluronan (H) is a major constituent of the cumulus matrix and may play a critical role in the selection of functionally competent sperm during in vivo fertilization. H-bound (HB) sperm exhibit increased levels of developmental maturity, sperm chromatin integrity and normal morphology. The relationship between HB-sperm and developmental competence led to the current study examining the use of HB-sperm in ICSI.

DESIGN: 208 ICSI patients were consented to participate in a prospectively randomized, double-blinded and IRB-approved study. To establish a 1:1 ratio between the number of patients with low versus high H binding assay (HBA®) indices, patients were randomized to the control (ICSI), study (PICSI) group or non-participatory group, each statistically equivalent.

MATERIALS AND METHODS: Sperm selected via the evaluation of motility and morphology were used in the ICSI of the control group and HB-sperm meeting the same criteria were used in the study group. The PICSI® plate used in the study provides microdots of H for sperm selection. Chi-square analyses for nominal data and independent t tests for normal continuous data were used to evaluate the data with SPSS 15.0.


Overall, the clinical pregnancy rate (cpr) in the PICSI study group was greater than that observed in the ICSI control group (44.8%, 37.9%, n = 67, 58). Stratifying by HBA® indices, patients with a low HBA® inde




demonstrated a greater cpr in the PICSI study group (44.8%, n = 29) than those patients in the ICSI control group (33.3%, n=33).

CONCLUSIONS: A clinically significant increase in cpr is associated with the use of HB-sperm, the increase being greater in those patients carrying an abnormal HBA score. The use of HB-sperm in ICSI may allow the isolation of more functionally competent sperm, thereby exerting a positive paternal influence on preimplantation embryogenesis and cpr. The ongoing study will continue to explore the enhanced embryonic potential associated with PICSI-derived embryos.

K.C.Worrilow and Associates, LLC, Fogelsville, Pennsylvania; Fertility Centers of Illinois, Chicago, IL; Huntington Reproductive Center, Laguna Hills, CA
Supported by: Support: PICSI® dishes by Biocoat, Inc.

PII: S0015-0282(09)01577-5

doi:10.1016/j.fertnstert.2009.07.141

© 2009 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

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