Iranian Red Crescent Medical Journal

Published by: Kowsar

Comparison of Intracytoplasmic Sperm Injection Outcome with Sperm Selection Techniques in Oligoasthenozoospermic Males: A Randomized Controlled Trial

Maryam Sefidgar Tehrani 1 , Malihe Amirian 2 , Mohsen Jalali 3 , Armin Attaranzadeh 3 , Alireza Fazel 1 , 4 and Alireza Ebrahimzadeh-Bideskan 1 , 4 , *
Authors Information
1 Department of Anatomy and Cell Biology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
2 Department of Reproductive Medicine and Gynecology, Milad (Mashhad) Infertility Center, Mashhad, Iran
3 Department of Reproductive Medicine, Milad (Mashhad) Infertility Center, Mashhad, Iran
4 Microanatomy Research Center, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
Article information
  • Iranian Red Crescent Medical Journal: 21 (1); e70656
  • Published Online: January 21, 2019
  • Article Type: Research Article
  • Received: April 26, 2018
  • Revised: November 10, 2018
  • Accepted: November 11, 2018
  • DOI: 10.5812/ircmj.70656

To Cite: Sefidgar Tehrani M, Amirian M , Jalali M , Attaranzadeh A , Fazel A, et al. Comparison of Intracytoplasmic Sperm Injection Outcome with Sperm Selection Techniques in Oligoasthenozoospermic Males: A Randomized Controlled Trial, Iran Red Crescent Med J. Online ahead of Print ; 21(1):e70656. doi: 10.5812/ircmj.70656.

Copyright © 2019, Author(s). This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License ( which permits copy and redistribute the material just in noncommercial usages, provided the original work is properly cited
1. Background
2. Objectives
3. Methods
4. Results
5. Discussion
  • 1. Agarwal A, Mulgund A, Hamada A, Chyatte MR. A unique view on male infertility around the globe. Reprod Biol Endocrinol. 2015;13:37. doi: 10.1186/s12958-015-0032-1. [PubMed: 25928197]. [PubMed Central: PMC4424520].
  • 2. Lamothe S, Kerlan V, Christin-Maitre S. [Semen quality and fertility: The role of the environment and health]. Ann Endocrinol (Paris). 2018;79 Suppl 1:S1-9. French. doi: 10.1016/S0003-4266(18)31233-2. [PubMed: 30213300].
  • 3. Song SH, Chiba K, Ramasamy R, Lamb DJ. Recent advances in the genetics of testicular failure. Asian J Androl. 2016;18(3):350-5. doi: 10.4103/1008-682X.178857. [PubMed: 27048782]. [PubMed Central: PMC4854078].
  • 4. Brezina PR, Zhao Y. The ethical, legal, and social issues impacted by modern assisted reproductive technologies. Obstet Gynecol Int. 2012;2012:686253. doi: 10.1155/2012/686253. [PubMed: 22272208]. [PubMed Central: PMC3261493].
  • 5. Hoorsan H, Mirmiran P, Chaichian S, Moradi Y, Hoorsan R, Jesmi F. Congenital malformations in infants of mothers undergoing assisted reproductive technologies: A systematic review and meta-analysis study. J Prev Med Public Health. 2017;50(6):347-60. doi: 10.3961/jpmph.16.122. [PubMed: 29207452]. [PubMed Central: PMC5717326].
  • 6. Avendano C, Oehninger S. DNA fragmentation in morphologically normal spermatozoa: How much should we be concerned in the ICSI era? J Androl. 2011;32(4):356-63. doi: 10.2164/jandrol.110.012005. [PubMed: 21088229].
  • 7. Aitken RJ, Koopman P, Lewis SEM. Male germs of concern. Nature. 2004;432:2-6.
  • 8. Parmegiani L, Cognigni GE, Bernardi S, Troilo E, Ciampaglia W, Filicori M. "Physiologic ICSI": Hyaluronic acid (HA) favors selection of spermatozoa without DNA fragmentation and with normal nucleus, resulting in improvement of embryo quality. Fertil Steril. 2010;93(2):598-604. doi: 10.1016/j.fertnstert.2009.03.033. [PubMed: 19393999].
  • 9. Menezo Y, Clement P, Amar E. Evaluation of sperm DNA structure, fragmentation and decondensation: An essential tool in the assessment of male infertility. Transl Androl Urol. 2017;6(Suppl 4):S553-6. doi: 10.21037/tau.2017.03.11. [PubMed: 29082177]. [PubMed Central: PMC5643722].
  • 10. Erberelli RF, Salgado RM, Pereira DH, Wolff P. Hyaluronan-binding system for sperm selection enhances pregnancy rates in ICSI cycles associated with male factor infertility. JBRA Assist Reprod. 2017;21(1):2-6. doi: 10.5935/1518-0557.20170002. [PubMed: 28333023]. [PubMed Central: PMC5365191].
  • 11. Nasr Esfahani MH, Deemeh MR, Tavalaee M, Sekhavati MH, Gourabi H. Zeta sperm selection improves pregnancy rate and alters sex ratio in male factor infertility patients: A double-blind, randomized clinical trial. Int J Fertil Steril. 2016;10(2):253-60. [PubMed: 27441060]. [PubMed Central: PMC4948079].
  • 12. Beck-Fruchter R, Shalev E, Weiss A. Clinical benefit using sperm hyaluronic acid binding technique in ICSI cycles: A systematic review and meta-analysis. Reprod Biomed Online. 2016;32(3):286-98. doi: 10.1016/j.rbmo.2015.12.001. [PubMed: 26776822].
  • 13. Simopoulou M, Gkoles L, Bakas P, Giannelou P, Kalampokas T, Pantos K, et al. Improving ICSI: A review from the spermatozoon perspective. Syst Biol Reprod Med. 2016;62(6):359-71. doi: 10.1080/19396368.2016.1229365. [PubMed: 27646677].
  • 14. Rossato M, Di Virgilio F, Foresta C. Involvement of osmo-sensitive calcium influx in human sperm activation. Mol Hum Reprod. 1996;2(12):903-9. [PubMed: 9237233].
  • 15. Stanger JD, Vo L, Yovich JL, Almahbobi G. Hypo-osmotic swelling test identifies individual spermatozoa with minimal DNA fragmentation. Reprod Biomed Online. 2010;21(4):474-84. doi: 10.1016/j.rbmo.2010.06.026. [PubMed: 20833108].
  • 16. Bassiri F, Tavalaee M, Shiravi AH, Mansouri S, Nasr-Esfahani MH. Is there an association between HOST grades and sperm quality? Hum Reprod. 2012;27(8):2277-84. doi: 10.1093/humrep/des155. [PubMed: 22595979].
  • 17. Rouen A, Carlier L, Heide S, Egloff M, Marzin P, Ader F, et al. Potential selection of genetically balanced spermatozoa based on the hypo-osmotic swelling test in chromosomal rearrangement carriers. Reprod Biomed Online. 2017;35(4):372-8. doi: 10.1016/j.rbmo.2017.06.017. [PubMed: 28711302].
  • 18. Charehjooy N, Najafi MH, Tavalaee M, Deemeh MR, Azadi L, Shiravi AH, et al. Selection of sperm based on hypo-osmotic swelling may improve ICSI outcome: A preliminary prospective clinical trial. Int J Fertil Steril. 2014;8(1):21-8. [PubMed: 24695913]. [PubMed Central: PMC3973167].
  • 19. Hox J, Roberts JK. Handbook of advanced multilevel analysis. 1st ed. New York: Routledge; 2011. p. 266-8.
  • 20. Pregl Breznik B, Kovacic B, Vlaisavljevic V. Are sperm DNA fragmentation, hyperactivation, and hyaluronan-binding ability predictive for fertilization and embryo development in in vitro fertilization and intracytoplasmic sperm injection? Fertil Steril. 2013;99(5):1233-41. doi: 10.1016/j.fertnstert.2012.11.048. [PubMed: 23290739].
  • 21. World Health Organisation. WHO laboratory manual for the examination of human semen and sperm-cervical mucus interaction. Cambridge University Press; 1999.
  • 22. Jayaraman V, Upadhya D, Narayan PK, Adiga SK. Sperm processing by swim-up and density gradient is effective in elimination of sperm with DNA damage. J Assist Reprod Genet. 2012;29(6):557-63. doi: 10.1007/s10815-012-9742-x. [PubMed: 22411295]. [PubMed Central: PMC3370043].
  • 23. Fernandez JL, Muriel L, Goyanes V, Segrelles E, Gosalvez J, Enciso M, et al. Simple determination of human sperm DNA fragmentation with an improved sperm chromatin dispersion test. Fertil Steril. 2005;84(4):833-42. doi: 10.1016/j.fertnstert.2004.11.089. [PubMed: 16213830].
  • 24. Heitmann RJ, Hill MJ, Richter KS, DeCherney AH, Widra EA. The simplified SART embryo scoring system is highly correlated to implantation and live birth in single blastocyst transfers. J Assist Reprod Genet. 2013;30(4):563-7. doi: 10.1007/s10815-013-9932-1. [PubMed: 23443889]. [PubMed Central: PMC3644132].
  • 25. Parmegiani L, Cognigni GE, Filicori M. New advances in intracytoplasmic sperm injection (ICSI). Advances in embryo transfer. InTech; 2012.
  • 26. Osman A, Alsomait H, Seshadri S, El-Toukhy T, Khalaf Y. The effect of sperm DNA fragmentation on live birth rate after IVF or ICSI: A systematic review and meta-analysis. Reprod Biomed Online. 2015;30(2):120-7. doi: 10.1016/j.rbmo.2014.10.018. [PubMed: 25530036].
  • 27. Sakkas D, Alvarez JG. Sperm DNA fragmentation: Mechanisms of origin, impact on reproductive outcome, and analysis. Fertil Steril. 2010;93(4):1027-36. doi: 10.1016/j.fertnstert.2009.10.046. [PubMed: 20080235].
  • 28. Zeqiraj A, Beadini S, Beadini N, Aliu H, Gashi Z, Elezaj S, et al. Male infertility and sperm DNA fragmentation. Open Access Maced J Med Sci. 2018;6(8):1342-5. doi: 10.3889/oamjms.2018.311. [PubMed: 30159053]. [PubMed Central: PMC6108823].
  • 29. Aydos OS, Yukselten Y, Kaplan F, Sunguroglu A, Aydos K. Analysis of the correlation between sperm DNA integrity and conventional semen parameters in infertile men. Turk J Urol. 2015;41(4):191-7. doi: 10.5152/tud.2015.98475. [PubMed: 26623148]. [PubMed Central: PMC4621147].
  • 30. Cho CL, Agarwal A. Role of sperm DNA fragmentation in male factor infertility: A systematic review. Arab J Urol. 2018;16(1):21-34. doi: 10.1016/j.aju.2017.11.002. [PubMed: 29713533]. [PubMed Central: PMC5922225].
  • 31. Simon L, Zini A, Dyachenko A, Ciampi A, Carrell DT. A systematic review and meta-analysis to determine the effect of sperm DNA damage on in vitro fertilization and intracytoplasmic sperm injection outcome. Asian J Androl. 2017;19(1):80-90. doi: 10.4103/1008-682X.182822. [PubMed: 27345006]. [PubMed Central: PMC5227680].
  • 32. Palermo GD, O'Neill CL, Chow S, Cheung S, Parrella A, Pereira N, et al. Intracytoplasmic sperm injection: State of the art in humans. Reproduction. 2017;154(6):F93-F110. doi: 10.1530/REP-17-0374. [PubMed: 29158352]. [PubMed Central: PMC5719728].
  • 33. Alvarez Sedo C, Bilinski M, Lorenzi D, Uriondo H, Noblia F, Longobucco V, et al. Effect of sperm DNA fragmentation on embryo development: Clinical and biological aspects. JBRA Assist Reprod. 2017;21(4):343-50. doi: 10.5935/1518-0557.20170061. [PubMed: 29116706]. [PubMed Central: PMC5714603].
  • 34. Seli E, Gardner DK, Schoolcraft WB, Moffatt O, Sakkas D. Extent of nuclear DNA damage in ejaculated spermatozoa impacts on blastocyst development after in vitro fertilization. Fertil Steril. 2004;82(2):378-83. doi: 10.1016/j.fertnstert.2003.12.039. [PubMed: 15302287].
  • 35. Sakkas D. The use of blastocyst culture to avoid inheritance of an abnormal paternal genome after ICSI. Hum Reprod. 1999;14(1):4-5. [PubMed: 10374083].
  • 36. Wang C, Feng G, Zhang B, Shu J, Zhou H, Gan X, et al. Influence of the insemination method on the outcomes of elective blastocyst culture. Clin Exp Reprod Med. 2017;44(2):85-9. doi: 10.5653/cerm.2017.44.2.85. [PubMed: 28795047]. [PubMed Central: PMC5545224].
  • 37. Rappa KL, Rodriguez HF, Hakkarainen GC, Anchan RM, Mutter GL, Asghar W. Sperm processing for advanced reproductive technologies: Where are we today? Biotechnol Adv. 2016;34(5):578-87. doi: 10.1016/j.biotechadv.2016.01.007. [PubMed: 26845061].
  • 38. Aitken RJ, Gordon E, Harkiss D, Twigg JP, Milne P, Jennings Z, et al. Relative impact of oxidative stress on the functional competence and genomic integrity of human spermatozoa. Biol Reprod. 1998;59(5):1037-46. [PubMed: 9780307].
  • 39. Westlander G, Barry M, Petrucco O, Norman R. Different fertilization rates between immotile testicular spermatozoa and immotile ejaculated spermatozoa for ICSI in men with Kartagener's syndrome: Case reports. Hum Reprod. 2003;18(6):1286-8. [PubMed: 12773460].
  • 40. Herbemont C, Sifer C. How to select the spermatozoon for intracytoplasmic sperm injection in 2015? Minerva Ginecol. 2015;67(2):185-93. [PubMed: 25581325].

Featured Image:

Creative Commons License Except where otherwise noted, this work is licensed under Creative Commons Attribution Non Commercial 4.0 International License .

Search Relations:



Create Citiation Alert
via Google Reader

Readers' Comments