Abstract
Purpose: Our purpose was to use effectively a simplified approach for intracytoplasmic sperm injection (ICSI) that achieves high levels of fertilization, embryo cleavage, and subsequent establishment of clinical pregnancies.
Methods: In a multicenter clinical analysis, 1814 mature oocytes were injected with a single sperm using a finely beveled (30°) pipette without a spiked tip that was backfilled with an inert, silicone polymer. The injection system was composed of a sterile water-filled tubing interconnecting the pipette and a 20-gauge needle attached to a three-way stopcock and 5-ml disposable syringe. The efficiency of the ICSI procedure was assessed by analyzing fertilization, lysis, and cleavage rates, as well as pregnancy outcomes.
Results: High levels of normal fertilization (2PN: 56.4–73.5% of all eggs injected) and reasonably low lysis rates (9–16%) were produced. The efficiency of embryo formation was high (87–93%), with only 6 of 177 (3.4%) patients failing to produce an embryo. Clinical pregnancies were established by each IVF center (18–34% ongoing pregnancy/birth rate).
Conclusions: Effective ICSI was achieved using a novel, simplified technique involving sharply beveled pipettes (without additional tip modification), simple sperm washing/handling procedures, and a disposable syringe injection system that offered extremely fine control for sperm manipulation.
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References
Palermo G, Joris H, Devroey P, Van Steirteghem AC: Pregnancies after intracytoplasmic injection of a single spermatozoon into an oocyte. Lancet 1992;340:17–18
Palermo G, Joris H, Derde M-P, Camus M, Devroey P, Van Steirteghem AC: Sperm characteristics and outcome of human assisted fertilization by subzonal insemination and intracytoplasmic sperm injection. Fertil Steril 1993;59:826–835
Van Steirteghem AC, Nagy Z, Joris H, Liu J, Staessen C, Smitz J, Wisanto A, Devroey P: High fertilization and implantation rates after intracytoplasmic sperm injection. Hum Reprod 1993;8:1061–1066
Uehara T, Yanagimuchi R: Microsurgical injection of spermatozoa into hamster eggs with subsequent transformation of sperm nuclei into male pronuclei. Biol Reprod 1976;15:467–470
Hosoi Y, Miyake M, Utsumi K, Iritani A: Development of rabbit oocytes after microinjection of spermatozoa. Proc 11th Int Congr Anim Reprod & Al, Dublin, 1988, Vol 3, p 331
Lanzendorf SE, Maloney MK, Veeck LL, Slusser J, Hodgen GD, Rosenwaks Z: A preclinical evaluation of human spermatozoa into human oocytes. Fertil Steril 1988;49:835–842
Nagy Z, Lui J, Cecile J, Silber S, Devroey P, Van Steirteghem A: Using ejaculated, fresh, and frozen-thawed epididymal and testicular spermatozoa gives rise to comparable results after intracytoplasmic sperm injection. Fertil Steril 1995;63:808–815
Silber SJ, Van Steirteghem AC, Lui J, Nagy Z, Tournaye H, Devroey P: High fertilization and pregnancy rate after intracytoplasmic sperm injection with spermatozoa obtained from testicle biopsy. Hum Reprod 1995;10:148–152
Palermo GD, Cohen J, Alikani M, Adler A, Rosenwaks Z: Intracytoplasmic sperm injection: A novel treatment for all forms of male factor infertility. Fertil Steril 1995;63:1231–1240
Tucker MJ, Wright G, Morton PC, Mayer MP, Ingargiola PE, Jones AE: Practical evolution and application of direct sperm injection for male factor and idiopathic fertilization failure infertilities. Fertil Steril 1995;63:820–827
Harari O, Bourne H, McDonald M, Richings N, Speirs AL, Johnston WIH, Baker HWG: Intracytoplasmic sperm injection: A major advance in the management of severe male subfertility. Fertil Steril 1995;64:360–368
Svalander P, Forsberg A-S, Jakobsson A-H, Wikland M: Factors of importance for the establishment of a successful program of intracytoplasmic sperm injection treatment for male infertility. Fertil Steril 1995;63:828–837
Fishel S, Timson J, Lisi F, Jacobson M, Rinaldi L, Gobetz L: Microassisted fertilization in patients who have failed subzonal insemination. Hum Reprod 1994;9:501–505
Fishel S, Lisi F, Rinaldi L, Green S, Hunter A, Dowell K, Thornton S: Systematic examination of immobilizing spermatozoa before intracytoplasmic sperm injection in the human. Hum Reprod 1995;10:497–500
Devroey P, Lui J, Nagy Z, Tournaye H, Silber SJ, Van Steirteghem AC: Normal fertilization of human oocytes after testicular sperm extraction and intracytoplasmic sperm injection. Fertil Steril 1994;62:639–641
Tournaye H, Devroey P, Lui J, Nagy Z, Lissens W, Van Steirteghem AC: Microsurgical epididymal sperm aspiration and intracytoplasmic sperm injection: A new effective approach to infertility as a result of congenital bilateral absence of the vas deferens. Fertil Steril 1994;61:1045–1051
Lui J, Nagy Z, Joris H, Tournaye H, Devroey P, Van Steirteghem AC: Intracytoplasmic sperm injection does not require special treatment of the spermatozoa. Hum Reprod 1994;9:1127–1130
Nagy Z, Lui J, Joris H, Verheyen, Tournaye H, Camus M, Derde M-P, Devroey P, Van Steirteghem A: The result of intracytoplasmic cytoplasmic sperm injection is not related to any of the three basic sperm parameters. Hum Reprod 1995;10:1123–1129.
Sherins RJ, Thorsell LP, Dorfmann A, Dennison-Lagos L, Calvo LP, Krysa L, Coulam CB, Schulman JD. Intracytoplasmic sperm injection facilitates fertilization even in the most severe forms of male infertility: Pregnancy outcome correlates with maternal age and number of eggs available. Fertil Steril 1995;64:369–375
Antinori S, Panci C, Caffa B, Selman HA, Dani G, de Pavova A, Versaci C: The RAPRUI Center experience: From SUZI, through lasers to ICSI using spermatozoa with broken tails. Hum Reprod 1995;10:489–491
Gerris J, Mangelschots K, Van Royen E, Joostens M, Eestermans W, Ryckaert G: ICSI and severe male-factor infertility: Breaking the sperm tail prior to injection. Hum Reprod 1995;10:484–486
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Schiewe, M.C. An effective, simplified, and practical approach to intracytoplasmic sperm injection at multiple IVF centers. J Assist Reprod Genet 13, 238–245 (1996). https://doi.org/10.1007/BF02065943
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DOI: https://doi.org/10.1007/BF02065943