Sperm Parameters Predicting Pregnancy Using Functional Selection of Spermatoza For ICSI (PICSI)

Introduction: Selecting spermatozoa for ICSI is most commonly based on morphology and motility criteria. Recently, new functional-based assays for selecting spermatozoa were introduced. Hyalronan is a major component of the oocyte surrounding matrix. Studies have shown an improvement in embryo quality and implantation rate using Hyalronan-bound sperm.

Aim: To investigate which sperm parameters predict pregnancy in a population undergoing IVF using functional selection of spermatozoa for ICSI (PICSI).

Materials and methods: Retrospective chart review study. Study population included all patients who underwent an IVF cycle using functional selection of spermatozoa for ICSI (PICSI) at Hadassah University Hospital- Mt Scopus during 2015-2016. Data reviewed included sperm concentration and motility detected for the native, freshly ejaculated sperm sample. We calculated the Hyalronan-bound sperm (HB) score by dividing the number of motile HB sperm by the number of motile sperm. Pregnancy rate was calculated per fresh embryo transfer.

Results: We reviewed a total of 67 PICSI cycles. Overall pregnancy rate was 36.5%. Cycles that resulted in pregnancy had a higher HB score (0.52+-0.29 vs 0.34 +- 0.26 respectively, p= 0.015), similar sperm concentration (41.9+-54.9 vs 24.7+-33.3 mil/ml respectively, p=NS) and a higher sperm motility rate (47.5+-34.8% vs 30.4+-22.9% respectively, p=0.012) when compared to cycles that did not result in pregnancy.

Conclusions: In our study, sperm motility rate and HB score were positively correlated with pregnancy in PICSI cycles, while sperm concentration was not. Although limited by sample size, we suggest that native sperm motility and HB score could assist in predicting PICSI success.