P-ICSI長~~什麼樣子？

P-ICSI長什麼樣子？8.9.7.10

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.

RESULTS: 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® index

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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