title: Outcomes of intracytoplasmic sperm injection using the zona pellucida-bound sperm or manually selected sperm.
abstract: OBJECTIVE
  Zona pellucida (ZP)-bound sperm used for intracytoplasmic sperm injection (ICSI) enhances embryo quality, implantation, and clinical pregnancy rates. This study aimed to assess the pregnancy outcomes and clinical significance of ICSI with ZP-bound sperm.
  
  
  METHODS
  A total of 84 infertile couples who underwent cycles of ICSI following failed in vitro fertilization between June 2012 and February 2014 were enrolled and randomized (1:1): in the treatment group, ICSI was performed using ZP-bound sperm; in the control group, ICSI was performed in a standard manner. Rates of fertilization, cleavage, high-quality embryos, and clinical pregnancy were compared between the two groups.
  
  
  RESULTS
  There were no significant differences in age, infertile period, gonadotrophin dose, number of metaphase II oocytes, and number of embryo transfers between the two groups (P > 0.05). The clinical pregnancy rate was higher in the treatment group than in the control group, but without statistical significance (60.5 vs. 47.6 %, P > 0.05). No significant differences in the rates of fertilization and cleavage were observed (83.0 vs. 81.6 %, and 96.3 vs. 96.5 %, both P > 0.05), but higher rates of high-quality embryos and useable embryos were observed with ZP-bound sperm compared with controls (66.1 vs. 50.8 % and 76.0 vs. 66.3 %, both P < 0.05).
  
  
  CONCLUSIONS
  ICSI using ZP-bound sperm might increase the embryo quality and number of useable embryos, possibly improving the clinical pregnancy outcome of ICSI.
authors.affiliation: Centre of Assisted Reproduction, Maternal and Children Health Care Hospital of Yinchuan, Yinchuan, 750000, Ningxia, China. mj980613@126.com.
authors.forename: Rui
authors.initials: R
authors.lastname: Jin
authors.affiliation: Centre of Assisted Reproduction, Maternal and Children Health Care Hospital of Yinchuan, Yinchuan, 750000, Ningxia, China. nancy197111@126.com.
authors.forename: Junhua
authors.initials: J
authors.lastname: Bao
authors.affiliation: Centre of Assisted Reproduction, Maternal and Children Health Care Hospital of Yinchuan, Yinchuan, 750000, Ningxia, China.
authors.forename: Dawei
authors.initials: D
authors.lastname: Tang
authors.affiliation: Centre of Assisted Reproduction, Maternal and Children Health Care Hospital of Yinchuan, Yinchuan, 750000, Ningxia, China.
authors.forename: Fang
authors.initials: F
authors.lastname: Liu
authors.affiliation: Centre of Assisted Reproduction, Maternal and Children Health Care Hospital of Yinchuan, Yinchuan, 750000, Ningxia, China.
authors.forename: Guoping
authors.initials: G
authors.lastname: Wang
authors.affiliation: Centre of Assisted Reproduction, Maternal and Children Health Care Hospital of Yinchuan, Yinchuan, 750000, Ningxia, China.
authors.forename: Yaqiong
authors.initials: Y
authors.lastname: Zhao
authors.affiliation: Centre of Assisted Reproduction, Maternal and Children Health Care Hospital of Yinchuan, Yinchuan, 750000, Ningxia, China.
authors.forename: Gang
authors.initials: G
authors.lastname: Bai
authors.affiliation: Centre of Assisted Reproduction, Maternal and Children Health Care Hospital of Yinchuan, Yinchuan, 750000, Ningxia, China.
authors.forename: Yongjie
authors.initials: Y
authors.lastname: Liu
authors.affiliation: Centre of Assisted Reproduction, Maternal and Children Health Care Hospital of Yinchuan, Yinchuan, 750000, Ningxia, China.
authors.forename: Ying
authors.initials: Y
authors.lastname: Wang
authors.affiliation: Centre of Assisted Reproduction, Maternal and Children Health Care Hospital of Yinchuan, Yinchuan, 750000, Ningxia, China.
authors.forename: Lili
authors.initials: L
authors.lastname: Liu
authors.affiliation: Centre of Assisted Reproduction, Maternal and Children Health Care Hospital of Yinchuan, Yinchuan, 750000, Ningxia, China.
authors.forename: Jing
authors.initials: J
authors.lastname: Zhao
mesh_terms: D000328:Adult; D004624:Embryo Transfer; D005260:Female; D006801:Humans; D011247:Pregnancy; D018873:Pregnancy Rate; D055101:Semen Analysis; D020554:Sperm Injections, Intracytoplasmic / Q000379:methods*; D013084:Sperm-Ovum Interactions; D016896:Treatment Outcome
keywords: Cleavage rate; Clinical pregnancy rate; Embryo transfer; Fertilization rate; High-quality embryo rate; In vitro fertilization; Intracytoplasmic sperm injection; Sperm-zona pellucida binding test