The IMSI Procedure Improves Laboratory and Clinical Outcomes Without Compromising the Aneuploidy Rate When Compared to the Classical ICSI Procedure

Clinical Medicine Insights-Reproductive Health Pub Date : 2015-01-01 DOI:10.4137/CMRH.S33032

D. Luna, Roly Hilario, Julio Dueñas-Chacón, R. Romero, Patricia Zavala, Lucy Villegas, J. García-Ferreyra

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引用次数: 25

Abstract

Purpose The intracytoplasmic morphologically selected sperm injection (IMSI) procedure has been associated with better laboratory and clinical outcomes in assisted reproduction technologies. Less information is available regarding the relationship between embryo aneuploidy rate and the IMSI procedure. The aim of this study is to compare the clinical outcomes and chromosomal status of IMSI-derived embryos with those obtained from intracytoplasmic sperm injection (ICSI) in order to establish a clearer view of the benefits of IMSI in infertile patients. Methods We retrospectively analyzed a total of 11 cycles of IMSI and 20 cycles of ICSI with preimplantation genetic diagnosis. The fertilization rate, cleavage rate, embryo quality, blastocyst development, aneuploidy rate, pregnancy rate, implantation rate, and miscarriage rate were compared between the groups. Results Similar rates of fertilization (70% and 73%), cleavage (98% and 100%), and aneuploidy (76.9% and 70.9%) were observed in the IMSI and ICSI groups, respectively. The IMSI group had significantly more good quality embryos at day 3 (95% vs 73%), higher blastocyst development rates (33% vs 19%), and greater number of hatching blastocysts (43% vs 28%), cycles with at least one blastocyst at day 5 (55% vs 35%), and blastocysts with good trophoectoderm morphology (21% vs 6%) compared with the ICSI group (P < 0.001). Significantly higher implantation rates were observed in the IMSI group compared with the ICSI group (57% vs 27%; P < 0.05). Pregnancy and miscarriage rates were similar in both groups (80% vs 50% and 0% vs 33%, respectively). Conclusion The IMSI procedure significantly improves the embryo quality/development by increasing the implantation rates without affecting the chromosomal status of embryos. There is a tendency for the IMSI procedure to enhance the pregnancy rates and lower the miscarriage rates when compared with ICSI.

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与传统ICSI手术相比，IMSI手术在不影响非整倍体率的情况下改善了实验室和临床结果

在辅助生殖技术中，胞浆内形态学选择精子注射(IMSI)与更好的实验室和临床结果有关。关于胚胎非整倍体率与IMSI程序之间关系的信息较少。本研究的目的是比较IMSI来源的胚胎与卵胞浆内单精子注射(ICSI)获得的胚胎的临床结果和染色体状况，以便更清楚地了解IMSI对不育患者的益处。方法回顾性分析11个周期IMSI和20个周期ICSI伴着床前遗传学诊断的病例。比较各组受精率、卵裂率、胚胎质量、囊胚发育、非整倍体率、妊娠率、着床率、流产率。结果IMSI组和ICSI组受精率分别为70%和73%，卵裂率分别为98%和100%，非整倍体率分别为76.9%和70.9%。与ICSI组相比，IMSI组在第3天有更多的优质胚胎(95%对73%)，更高的囊胚发育率(33%对19%)，更多的孵化囊胚(43%对28%)，第5天至少有一个囊胚周期(55%对35%)，囊胚具有良好的滋养外胚层形态(21%对6%)(P < 0.001)。IMSI组的着床率明显高于ICSI组(57% vs 27%;P < 0.05)。两组的妊娠率和流产率相似(分别为80%对50%和0%对33%)。结论IMSI在不影响胚胎染色体状态的情况下，提高了胚胎着床率，显著改善了胚胎质量/发育。与ICSI相比，IMSI有提高妊娠率和降低流产率的趋势。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical Medicine Insights-Reproductive Health OBSTETRICS & GYNECOLOGY-

自引率

0.00%

发文量

审稿时长

8 weeks

期刊介绍： Clinical Medicine Insights: Reproductive Health is a peer reviewed; open access journal, which covers all aspects of Reproduction: Gynecology, Obstetrics, and Infertility, spanning both male and female issues, from the physical to the psychological and the social, including: sex, contraception, pregnancy, childbirth, and related topics such as social and emotional impacts. It welcomes original research and review articles from across the health sciences. Clinical subjects include fertility and sterility, infertility and assisted reproduction, IVF, fertility preservation despite gonadotoxic chemo- and/or radiotherapy, pregnancy problems, PPD, infections and disease, surgery, diagnosis, menopause, HRT, pelvic floor problems, reproductive cancers and environmental impacts on reproduction, although this list is by no means exhaustive Subjects covered include, but are not limited to: • fertility and sterility, • infertility and ART, • ART/IVF, • fertility preservation despite gonadotoxic chemo- and/or radiotherapy, • pregnancy problems, • Postpartum depression • Infections and disease, • Gyn/Ob surgery, • diagnosis, • Contraception • Premenstrual tension • Gynecologic Oncology • reproductive cancers • environmental impacts on reproduction, • Obstetrics/Gynaecology • Women''s Health • menopause, • HRT, • pelvic floor problems, • Paediatric and adolescent gynaecology • PID