title: Sperm vacuoles negatively affect outcomes in intracytoplasmic morphologically selected sperm injection in terms of pregnancy, implantation, and live-birth rates.
abstract: OBJECTIVE
  To retrospectively evaluate whether sperm vacuoles influence clinical results, with a particular focus on live-birth rates, in 101 intracytoplasmic morphologically selected sperm injection (IMSI) cycles.
  
  
  METHODS
  Retrospective, observational study.
  
  
  METHODS
  Medical center.
  
  
  METHODS
  A total of 101 couples with at least two failed intracytoplasmic sperm injection (ICSI) attempts and impaired sperm morphology.
  
  
  METHODS
  Patients divided into two groups according to sperm morphology and vacuolization pattern: group A comprising patients with good quality spermatozoa (type I and/or type II spermatozoa) (n = 63 patients); group B comprising patients with low quality spermatozoa (type III and/or IV spermatozoa) (n = 38 patients).
  
  
  METHODS
  Fertilization rate, embryo quality, pregnancy, implantation, and live-birth rates.
  
  
  RESULTS
  No statistically significant differences were observed between group A and B with regard to "early" assisted reproduction outcomes (fertilization rate and embryo quality). However, the "late" outcomes (pregnancy, implantation, and live-birth rates) were statistically significantly higher in group A.
  
  
  CONCLUSIONS
  These results confirm a correlation between sperm vacuoles and a negative IMSI outcome, suggesting that sperm vacuoles are related to the late paternal effect.
authors.affiliation: Centre for Reproductive Medicine, European Hospital, Rome, Italy. ergreco1@virgilio.it
authors.forename: Ermanno
authors.initials: E
authors.lastname: Greco
authors.forename: Filomena
authors.initials: F
authors.lastname: Scarselli
authors.forename: Gemma
authors.initials: G
authors.lastname: Fabozzi
authors.forename: Alessandro
authors.initials: A
authors.lastname: Colasante
authors.forename: Daniela
authors.initials: D
authors.lastname: Zavaglia
authors.forename: Erminia
authors.initials: E
authors.lastname: Alviggi
authors.forename: Katarzyna
authors.initials: K
authors.lastname: Litwicka
authors.forename: Maria Teresa
authors.initials: MT
authors.lastname: Varricchio
authors.forename: Maria Giulia
authors.initials: MG
authors.lastname: Minasi
authors.forename: Jan
authors.initials: J
authors.lastname: Tesarik
mesh_terms: D000328:Adult; D002469:Cell Separation; D048430:Cell Shape; D010064:Embryo Implantation / Q000502:physiology; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D050498:Live Birth / Q000453:epidemiology; D008297:Male; D011247:Pregnancy; D011256:Pregnancy Outcome / Q000453:epidemiology*; D018873:Pregnancy Rate; D012189:Retrospective Studies; D020554:Sperm Injections, Intracytoplasmic / Q000379:methods; D013094:Spermatozoa / Q000166:cytology* / Q000502:physiology / Q000648:ultrastructure*; D016896:Treatment Outcome; D014617:Vacuoles / Q000502:physiology*
keywords: Clinical outcomes; IMSI; intracytoplasmic; live-birth rate; morphologically selected sperm injection; vacuoles