title: The efficiency of conventional microscopic selection is comparable to the hyaluronic acid binding method in selecting spermatozoa for male infertility patients.
abstract: OBJECTIVE
  To evaluate if hyaluronic acid (HA)-bound spermatozoa surpassed conventional microscopy-selected spermatozoa in the status of sperm DNA integrity by acridine orange (AO) fluorescence staining.
  
  
  METHODS
  Spermatozoa obtained from couples with indication for the intracytoplasmic sperm injection (ICSI) procedure due to male infertility (n = 34) and control males with normal sperm parameters (n = 12) were analyzed using AO fluorescence staining after density-gradient centrifugation (DGC), polyvinylpyrrolidone (PVP)-microscopic selection, and HA-binding selection to determine sperm DNA integrity.
  
  
  RESULTS
  Percentages of DNA intact spermatozoa with green fluorescence were significantly higher in both PVP-microscopic selected spermatozoa (82.1 ± 24.0%) and HA-bound spermatozoa (83.9 ± 21.1%) than in spermatozoa prepared by DGC (66.8 ± 24.0%). However, there was no significant difference between the PVP-sperm and HA-sperm groups. When the percentage of green fluorescent spermatozoa prepared by DGC fell initially below 68%, both PVP-microscopic and HA-binding selection failed to select over 90% spermatozoa with intact DNA for ICSI in the male infertility group. Compared to control males with normal sperm parameters (99.3 ± 1.8%), the proportion of green fluorescence sperm after HA-binding selection from couples with male infertility (83.9 ± 21.1%) did not reach the range of > 99% reported by Yagci et al.
  
  
  CONCLUSIONS
  The percentages of DNA intact spermatozoa between the PVP-sperm and HA-sperm groups were not significantly different. In an ICSI procedure, a well-trained embryologist will have the same ability to choose sperm with intact DNA by conventional microscopic selection as with HA-bound spermatozoa selection.
authors: Department of Obstetrics and Gynecology, Mackay Memorial Hospital, Taipei, Taiwan.
authors: Meng-Ting
authors: MT
authors: Huang
authors: Department of Obstetrics and Gynecology, Mackay Memorial Hospital, Taipei, Taiwan; Department of Medical Research, Mackay Memorial Hospital, Taipei, Taiwan; Department of Obstetrics and Gynecology, Taipei Medical University, Taipei, Taiwan.
authors: Robert
authors: R
authors: Kuo-Kuang Lee
authors: Department of Medical Research, Mackay Memorial Hospital, Taipei, Taiwan.
authors: Chung-Hao
authors: CH
authors: Lu
authors: Department of Obstetrics and Gynecology, Mackay Memorial Hospital, Taipei, Taiwan.
authors: Ying-Jie
authors: YJ
authors: Chen
authors: Department of Medical Research, Mackay Memorial Hospital, Taipei, Taiwan; Mackay Medicine, Nursing and Management College, Taipei, Taiwan.
authors: Sheng-Hsiang
authors: SH
authors: Li
authors: Department of Obstetrics and Gynecology, Mackay Memorial Hospital, Taipei, Taiwan; Department of Medical Research, Mackay Memorial Hospital, Taipei, Taiwan; Mackay Medicine, Nursing and Management College, Taipei, Taiwan; Mackay Medical College, Taipei, Taiwan. Electronic address: hwu4416@yahoo.com.tw.
authors: Yuh-Ming
authors: YM
authors: Hwu
mesh_terms: D000328:Adult; D053938:DNA Fragmentation / Q000187:drug effects; D010064:Embryo Implantation; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006820:Hyaluronic Acid / Q000008:administration & dosage*; D007248:Infertility, Male / Q000175:diagnosis / Q000188:drug therapy* / Q000235:genetics; D008297:Male; D012189:Retrospective Studies; D020554:Sperm Injections, Intracytoplasmic / Q000379:methods*; D053625:Sperm Retrieval; D013094:Spermatozoa / Q000166:cytology / Q000187:drug effects* / Q000502:physiology; D016896:Treatment Outcome; D055675:Viscosupplements / Q000008:administration & dosage
chemical_list: D055675:Viscosupplements; D006820:Hyaluronic Acid
keywords: PVP-ICSI; acridine orange fluorescence test; hyaluronic acid selection; sperm DNA integrity; sperm selection