title: Predicting the clinical outcome of ICSI by sperm head vacuole examination.
abstract: To assess whether high magnification sperm head vacuole examination (SHVE) and/or standard sperm morphology assessment can predict ICSI outcomes in terms of fertilization, embryo quality, and delivery rates, a prospective observational bicentric study was conducted in two publicly funded assisted reproductive technology (ART) units in France between January and July of 2012. A total of 111 ICSI cycles for exclusively male infertility factors were included. A Spearman's correlation test was performed to validate SHVE reproducibility between the ART units. The normal morphology rate and SHVE performed on selected spermatozoa were respectively determined according to David's and Vanderzwalmen's classifications used for motile sperm organelle morphology examination (MSOME) on the day of the ICSI. Receiver Operating Characteristic (ROC) curve analysis was performed to determine thresholds associated with the occurrence of a delivery. There was an excellent correlation between the two operators (r=0.98), thus validating the study's SHVE data. Percentages of normal morphology grade spermatozoa using the standard classification and first-best morphology grade spermatozoa determined by SHVE were not significantly associated with (i) delivery (p=0.58; 0.90 /area under curve (AUC) =0.532; 0.507), (ii) fertilization (p=0.88; 0.90), (iii) top-quality embryos (p=0.27; 0.98), and (iv) good quality embryo rates (p=0.73; 0.98), respectively. In conclusion, high magnification SHVE and standard sperm morphology assessment cannot predict clinical or biological ICSI outcomes.
  
  
  BACKGROUND
  ART: assisted reproductive technology; HBV: hepatitis B virus; HCV: hepatitis C virus; HIV: human immunodeficiency virus; ICSI: intra-cytoplasmic sperm injection; IVF: in vitro fertilization; LNVs: large nuclear vacuoles; MSOME: motile sperm organelle morphology examination; SHVE: sperm head vacuole examination; WHO: World Health Organization.
authors.affiliation: a Cochin-Port Royal University Hospital , IVF Laboratory Unit , Paris , France.
authors.forename: Khaled
authors.initials: K
authors.lastname: Pocate-Cheriet
authors.affiliation: b Jean Verdier University Hospital , IVF Laboratory Unit , Bondy , France.
authors.forename: Ilan
authors.initials: I
authors.lastname: Heilikman
authors.affiliation: c Saint-Louis University Hospital , Bio-statistical analysis unit , Paris , France.
authors.forename: Raphael
authors.initials: R
authors.lastname: Porcher
authors.affiliation: a Cochin-Port Royal University Hospital , IVF Laboratory Unit , Paris , France.
authors.forename: Virginie
authors.initials: V
authors.lastname: Barraud-Lange
authors.affiliation: b Jean Verdier University Hospital , IVF Laboratory Unit , Bondy , France.
authors.forename: Nathalie
authors.initials: N
authors.lastname: Sermondade
authors.affiliation: b Jean Verdier University Hospital , IVF Laboratory Unit , Bondy , France.
authors.forename: Charlene
authors.initials: C
authors.lastname: Herbemont
authors.affiliation: a Cochin-Port Royal University Hospital , IVF Laboratory Unit , Paris , France.
authors.forename: Jean Philippe
authors.initials: JP
authors.lastname: Wolf
authors.affiliation: b Jean Verdier University Hospital , IVF Laboratory Unit , Bondy , France.
authors.forename: Christophe
authors.initials: C
authors.lastname: Sifer
mesh_terms: D000328:Adult; D019540:Area Under Curve; D005260:Female; D005298:Fertility; D006801:Humans; D007248:Infertility, Male / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D050498:Live Birth; D008297:Male; D010297:Paris; D011237:Predictive Value of Tests; D011247:Pregnancy; D018873:Pregnancy Rate; D011446:Prospective Studies; D012372:ROC Curve; D015203:Reproducibility of Results; D013077:Sperm Head / Q000473:pathology*; D020554:Sperm Injections, Intracytoplasmic / Q000009:adverse effects; D016896:Treatment Outcome; D014617:Vacuoles / Q000473:pathology*
keywords: High magnification; ICSI outcomes; MSOME; sperm morphology