A study of to determine if limiting the contact of sperm with zona pellucida reduces the rate of spontaneous abortions.
A recent study suggested that oligoasthenozoospermia may be an etiologic factor for spontaneous abortion (SAB) after in vitro fertilization-embryo transfer (IVF-ET). However, IVF-ET with intracytoplasmic sperm injection (ICSI) did not seem to be associated with an increased SAB rate. The study presented herein compared the rate of SAB in pregnancies achieved by IVF-ET according to the type of oocyte insemination process. The 3 types evaluated were conventional insemination, which exposed the oocyte to 25,000 sperm with prolonged contact (16-24 h), intermediate contact with a short insemination protocol where contact with 25,000 sperm was limited to 2 h, and very limited contact with ICSI, where only 1 sperm was injected into the oocyte thus not exposing the zona pellucida to any sperm. The patients were further subdivided into age groups of < or =39 or > or =40. SAB rates after frozen ET were also evaluated. The clinical pregnancy and SAB rates following fresh or frozen ET for conventional, ICSI, and short insemination techniques for the 2 age groups were comparable. These data question whether oligoasthenozoospermia may be a factor in causing SAB, and whether avoidance of contact with the zona pellucida by using ICSI can negate this effect. A larger study is needed.
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M L
ML
The University of Medicine and Dentistry of New Jersey, Robert Wood Johnson Medical School at Camden, Cooper Hospital/University Medical Center, Department of Obstetrics and Gynecology, USA.
Katsoff
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J H
JH
Swenson
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K
D000022:Abortion, Spontaneous / Q000209:etiology / Q000517:prevention & control*; D000328:Adult; D010064:Embryo Implantation; D004624:Embryo Transfer; D005260:Female; D005307:Fertilization in Vitro / Q000379:methods; D006801:Humans; D007315:Insemination, Artificial / Q000502:physiology; D008297:Male; D011247:Pregnancy; D018873:Pregnancy Rate; D011446:Prospective Studies; D020554:Sperm Injections, Intracytoplasmic; D013084:Sperm-Ovum Interactions / Q000502:physiology*; D013094:Spermatozoa / Q000502:physiology*; D013997:Time Factors; D015044:Zona Pellucida / Q000502:physiology*