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The possibility of integrating motile sperm organelle morphology examination (MSOME) with intracytoplasmic morphologically-selected sperm injection (IMSI) when treating couples with unexplained infertility.

在治疗不明原因不孕夫妇时,将运动精子细胞器形态学检查 (mseme) 与胞浆内形态选择精子注射 (IMSI) 相结合的可能性。

  • 影响因子:3.02
  • DOI:10.1371/journal.pone.0232156
  • 作者列表:"Asali A","Miller N","Pasternak Y","Freger V","Belenky M","Berkovitz A
  • 发表时间:2020-05-01
Abstract

PURPOSE:To examine the efficacy of motile sperm organelle morphology examination (MSOME) and intracytoplasmic morphologically-selected sperm injection (IMSI) for unexplained infertility. METHODS:This historical study, included 271 couples with primary, unexplained infertility/male subfertility, treated at an outpatient, IVF clinic, 2015-2018. These couples underwent MSOME after ≥3 failed intrauterine insemination (IUI) cycles and ≥1 failed IVF-ICSI cycle. They proceeded to intracytoplasmic morphologically-selected sperm injection (IMSI) within 6 months of MSOME. IMSI is conducted on the day of oocyte pick-up with a fresh semen sample. Pregnancy and delivery rates were analyzed. RESULTS:The cohort was divided based on percentage of normal cells at MSOME: Group A included 55 with no normal cells, Group B, 184 with 0.5%≤ normal cells ≤1.5% and Group C, 32 with ≥2% normal cells. Normal spermatozoa were found in 49 (89%) of Group A after extensive search. Group A had higher pregnancy rate (62.7%) compared to B (47.2%, P = 0.05) and C (28.1%, P = 0.002). Group B had higher pregnancy rate than C (p = 0.045). Delivery rate was higher in Group A (52.1%) compared to B (34.1%, p = 0.023) and C (21.9%, p = 0.007). Pregnancy and delivery rates were higher in A compared to B+C (p = 0.018, p = 0.01, respectively). CONCLUSIONS:MSOME may be useful for evaluating unexplained infertility. IMSI can be recommended for men with <2% normal spermatozoa at MSOME.

摘要

目的: 探讨运动精子细胞器形态学检查 (MSOME) 和卵胞浆内形态选择精子注射 (IMSI) 对不明原因不孕的疗效。 方法: 这项历史研究,包括271对原发性,不明原因不育/男性生育力低下的夫妇,在门诊治疗,IVF诊所,2015-2018。这些夫妇在 ≥ 3个失败的宫腔内人工授精 (IUI) 周期和 ≥ 1个失败的ivf-icsi周期后接受了MSOME。他们在6个月内进行胞浆内形态学选择精子注射 (IMSI)。IMSI在采集卵母细胞的当天用新鲜精液样品进行。分析妊娠率和分娩率。 结果: 根据MSOME时正常细胞的百分比划分队列: A组包括55个无正常细胞,B组184个0.5% 个 ≤ 正常细胞 ≤ 1.5% 个,C组32个 ≥ 2% 个正常细胞。经广泛检索,A组中49例 (89%) 发现正常精子。A组妊娠率 (62.7%) 高于B组 (47.2%,P = 0.05) 和C组 (28.1%,P = 0.002)。B组妊娠率高于C组 (p = 0.045)。A组的分娩率 (52.1%) 高于B组 (34.1%,p = 0.023) 和C组 (21.9%,p = 0.007)。A组的妊娠率和分娩率高于B + C组 (分别为p = 0.018,p = 0.01)。 结论: MSOME可用于不明原因不孕的评估。IMSI可推荐用于在MSOME时具有 <2% 正常精子的男性。

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不孕症方向

不孕症分为男性不育和女性不孕,其首要病因诊断依次是:排卵障碍、精液异常、输卵管异常、不明原因的不孕、子宫内膜异位症和其他如免疫学不孕。

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