title: Isolating sperm by selecting those with normal nuclear morphology prior to intracytoplasmic sperm injection (ICSI) does not provide better pregnancy rates compared to conventional ICSI in women with repeated conception failure with in vitro fertilization.
abstract: OBJECTIVE
  To determine if isolation of sperm by nuclear characteristics using high magnification offers any advantage over the normal morphologic methods when performing intracytoplasmic sperm injection (ICSI) in refractory cases in which the male partner had an abnormal DNA fragmentation index.
  
  
  METHODS
  Women aged < or = 39 with failure to have a successful conception after three consecutive embryo transfers whose male partner had a DNA fragmentation index > 30% were randomly assigned to isolation of sperm for ICSI by a new high magnification procedure to evaluate nuclear morphology and the usual method with normal magnification where nuclear characteristics were not seen. Women 40-43 were not randomized and were given the option after hearing pros and cons.
  
  
  RESULTS
  Overall the live delivered pregnancy rates were similar in the high vs normal magnification groups (33.3% vs 36.3%).
  
  
  CONCLUSIONS
  Isolation of sperm with normal nuclei with high magnification does not offer any advantage over conventional IVF for refractory cases where the male partner has a high DNA fragmentation index.
authors.affiliation: 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 Division of Reproductive Endocrinology & Infertility, Camden, NJ, USA. laurie@ccivf.com
authors.forename: J H
authors.initials: JH
authors.lastname: Check
authors.forename: A
authors.initials: A
authors.lastname: Bollendorf
authors.forename: D
authors.initials: D
authors.lastname: Summers-Chase
authors.forename: W
authors.initials: W
authors.lastname: Yuan
authors.forename: D
authors.initials: D
authors.lastname: Horwath
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D008297:Male; D011247:Pregnancy; D018873:Pregnancy Rate; D020554:Sperm Injections, Intracytoplasmic; D013094:Spermatozoa / Q000166:cytology*