: Hum Reprod. 2003 Jul;18(7):1371-6.

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Lower sperm aneuploidy frequency is associated with high pregnancy rates in ICSI programmes.

Burrello N, Vicari E, Shin P, Agarwal A, De Palma A, Grazioso C, D'Agata R, Calogero AE.

Section of Endocrinology, Andrology and Internal Medicine, Department of Biomedical Sciences, University of Catania, Catania, Italy.

BACKGROUND: A large proportion of patients undergoing ICSI have been shown to have an increased sperm aneuploidy rate. This study was undertaken to evaluate the impact of sperm aneuploidy on ICSI outcome. METHODS: To accomplish this, 48 consecutive unselected male patients (median age 34 years) had their sperm aneuploidy rate evaluated in the same swim-up preparation used for ICSI. Chromosomes 8, 12, 18, X and Y were evaluated by fluorescence in-situ hybridization. Patients were divided into two groups (A and B) based on the sperm aneuploidy frequency in their sperm. Group A had values below and group B above the upper limit of normal [1.55%, determined in 14 healthy men (median age 25 years) with normal semen parameters by WHO 1999 criteria (control group)]. RESULTS: Group A consisted of 12 patients (25%) whose sperm aneuploidy rates fell below the cut-off value of the control group (median 1.25%; range 0.85-1.52). Group B consisted of the remaining 36 patients (75%), who had an elevated sperm aneuploidy rate (median 3.25%; range 1.64-23.60). Fertilization (93 versus 85%) and cleavage (100 versus 98%) rates were similar for both groups. Group A had significantly higher clinical pregnancy (75 versus 34%; P < 0.001) and implantation (34 versus 13%; P < 0.001) rates compared with group B. In addition, group A had a lower overall miscarriage rate (11.1 versus 38.9%). Other factors that affect pregnancy and implantation, such as patient age and conventional semen parameters, were similar for both groups. CONCLUSION: This study showed that chromosomally abnormal sperm have a negative impact on ICSI outcome.

PMID: 12832359 [PubMed - indexed for MEDLINE]

Human Reproduction, Vol. 16, No. 7, 1433-1439, July 2001
© 2001 European Society of Human Reproduction and Embryology

High sperm aneuploidy rate in unselected infertile patients and its relationship with intracytoplasmic sperm injection outcome

Aldo E. Calogero^1,5, Adele De Palma¹, Caterina Grazioso^1,2, Nunziata Barone¹, Nunziatina Burrello¹, Irina Palermo¹, Antonio Gulisano³, Carlo Pafumi⁴ and Rosario D'Agata¹

¹ Division of Endocrinology and Master in Andrological Sciences, New Methodologies in Human Reproductive Medicine, University of Catania, Catania, ² Master in Endocrinological and Metabolic Sciences, University of Naples, Naples, ³ Department of Obstetrics and Gynaecology and ⁴ Department of Microbiology and Obstetrical Science, University of Catania, Catania, Italy

BACKGROUND: Men with oligoasthenoteratozoospermia (OAT) frequently undergo intracytoplasmic sperm injection (ICSI) as a treatment for their infertility. However, there is an increased risk of transmitting chromosomal abnormalities to the offspring given that natural selection is bypassed by the use of this technique and patients have an increased rate of sperm aneuploidy which, in addition, may negatively affect ICSI outcome. For this reason, the rate of sperm aneuploidy in unselected patients undergoing ICSI and its impact on ICSI performance have been evaluated. METHODS: Aneuploidy and diploidy were evaluated in spermatozoa separated by swim-up for oocyte injection, using DNA probes for chromosomes 8, 12, 18, X and Y. RESULTS: ICSI patients had sperm aneuploidy and diploidy rates significantly higher than those of 13 normozoospermic men who served as controls. Although the total aneuploidy rate varied considerably between the 18 patients, 15 of them (83%) had values above the upper range of the control group. Eighteen ICSI cycles were performed with an overall fertilization rate of 95% and a pregnancy rate of 39%. The aneuploidy rate of the 11 patients whose wives did not achieve pregnancy was slightly higher than that of pregnant couples, but the difference did not reach statistical significance. However, 10 patients in this group (91%) had a sperm aneuploidy rate well above the upper limit of the controls as compared with two patients in the `pregnant' group (29%). CONCLUSIONS: This study has shown that unselected patients undergoing ICSI had an elevated sperm aneuploidy rate. Lack of pregnancy was associated with a tendency towards an increased aneuploidy rate; however, pregnancy occurred even in the presence of an elevated sperm aneuploidy rate.

Keywords: aneuploidy • chromosome 8, 12, 18, X and Y • fluorescent in-situ-hybridization • intracytoplasmic sperm injection • oligoasthenoteratozoospermia

⁵ To whom correspondence should be addressed at: Cattedra