The impact of spermatozoa preincubation time and spontaneous acrosome reaction in intracytoplasmic sperm injection: a controlled randomized study.
OBJECTIVE
To determine the optimum time interval between semen processing and incubation before intracytoplasmic sperm injection (ICSI) and correlate it with the acrosomal reaction rate.


METHODS
Controlled randomized study.


METHODS
The Egyptian IVF-ET Center.


METHODS
Couples with male factor infertility undergoing ICSI using ejaculated semen.


METHODS
The patients were prospectively randomized according to differences in sperm preincubation time before ICSI into 1-hour, 3-hour, and 5-hour groups. The status of the acrosome was studied using electron microscopy.


METHODS
The primary outcome measures were fertilization rate and acrosome reaction rate. Secondary outcome measures were the implantation and pregnancy rates.


RESULTS
The rate of acrosomally reacted spermatozoa was the highest (68.2%) after 5 hours of incubation and lowest (25.6%) after 1 hour of incubation. The difference was statistically significant. The fertilization rate was the highest (74%) using spermatozoa incubated for 3 hours as compared with 1 hour (70%) and 5 hours (67%), but the difference was not statistically significant.


CONCLUSIONS
Acrosome reaction is time dependent; the optimum incubation time of spermatozoa before ICSI was 3 hours, which resulted in the highest fertilization rate.
Mansour
Ragaa T
RT
The Egyptian IVF-ET Center, Cairo, Egypt. ragaaivf@hotmail.com
Serour
Mennatallah G
MG
Abbas
Amal M
AM
Kamal
Ahmed
A
Tawab
Nevine A
NA
Aboulghar
Mohamed A
MA
Serour
Gamal I
GI
D020101:Acrosome Reaction; D000328:Adult; D004534:Egypt / Q000453:epidemiology; D005260:Female; D006801:Humans; D007248:Infertility, Male / Q000453:epidemiology* / Q000628:therapy*; D008297:Male; D011247:Pregnancy; D018873:Pregnancy Rate; D012662:Semen Preservation / Q000379:methods* / Q000706:statistics & numerical data*; D020554:Sperm Injections, Intracytoplasmic / Q000706:statistics & numerical data*; D013997:Time Factors; D016896:Treatment Outcome