Search

Purpose: To find an effective method to select embryos from ICSI with better chromosomal status when preimplantation-genetic-diagnosis (PGD) is not applied., Methods: Several morpholological evaluations were done in same embryos. Embryos from ICSI were classified on day 1 according to pronuclear-nucleoli arrangement. On day 3, classification was done according to number, fragmentation, size and shape of cells. In some patients, embryos exhibiting good quality on day 3 (at least six regular blastomeres with cell fragmentation lower than 20%) were also submitted to PGD, irrespective to pronuclear-nucleoli morphology., Results: Forty-two per cent of normally fertilized embryos showed pronuclear-nucleoli-good-morphology; from those, 86% were also classified as good quality on day 3. Good-quality embryos submitted to PGD have shown lower chromosomal abnormality rates when also classified as pronuclear-nucleoli-good-morphology., Conclusions: Pronuclear-nucleoli morphology seems to be correlated with PGD results. This criterion may prove useful for pre-select embryos with normal chromosomal package when PGD is not applied.

Purpose: To evaluate the relationship between the postvasectomy period and sperm reproductive capacity after ICSI., Methods: Seventy-seven ICSI cycles with percutaneous epididymal sperm aspiration (PESA) were reviewed. Patients were divided into 4 groups according to the interval after vasectomy: 0 - 5 years (G1); 6 - 8 years (G2); 9 - 14 years (G3), and > 15 years (G4)., Results: Clinical and ongoing pregnancy rates did not correlate significantly with the time period of vasectomy until 14 years. Although the higher implantation rate observed in G1, no significant differences were noted among Groups 1-3. The miscarriage rates increased from G1 to G4, reaching a statistical significance among G1, G2, and G3 compared with G4. When groups were also divided according to the maternal age, the same results were obtained., Conclusions: The interval between the vasectomy and the sperm retrieval procedure has no effect on the outcome until the interval of 14 years.

Purpose: To analyze best parameter to select embryos according to sperm origin in ICSI cycles., Methods: One hundred seventy-two ICSI cycles were divided among three different groups: A (ejaculated spermatozoa from nonmale factor infertility), B (ejaculated spermatozoa from oligospermia), and C (spermatozoa from azoospermia). Embryos were divided on Day 1 into two patterns: S0 (pronuclei (PN) aligned and close with normal arrangement of nucleoli) and S1 (when these characteristics were absent) and also on transfer day according to morphological features., Results: Relationships of PN patterns related to sperm origin were noted. More S0 embryos were detected with better sperm quality. Higher number of good quality embryos was obtained when male factor was absent. Ejaculated and epididymal spermatozoa provide better quality embryos than do testicular spermatozoa., Conclusions: PN classification associated with transfer day morphology is valuable additional noninvasive criterion for elective embryo transfer, mainly in the cases with severe male factor.