Can Hypo-osmotic Swelling Test (Host) Improve Pregnancy Outcomes in Unexplained Iinfertility Patients with Normal Semen Parameters Undergoing ICSI –Frozen Embryo Transfer Cycles?

Can Hypo-osmotic Swelling Test (Host) Improve Pregnancy Outcomes in Unexplained Iinfertility Patients with Normal Semen Parameters Undergoing ICSI –Frozen Embryo Transfer Cycles?

Objective: The objective of this study is to compare the pregnancy outcomes of the couples who underwent Hypo-Osmotıc Swelling Test (HOST) as a sperm selection method in Intracytoplasmic sperm injection (ICSI) – Frozen embryo transfer (ET) cycles and those who did not. Methods: ICSI – Frozen ET cycles, employing HOST as a sperm selection method were assigned to the Study Group; whereas those not employing HOST were included in the Control Group. Both study and control groups were divided into two subgroups according to the age of the women; those between the 25-35 years old and those between 36-40. The study and the control group included 509 and 1304 patients; respectively. Patients between 25-40 years old, who received Invitro fertilization (IVF) treatment for the first time, had good quality (grade A) blastocyst embryo on the 5th day, had normal semen parameters and HOST scores of b, c, and d were included in the study. Results: Pregnancy outcomes were comparable between cycles using HOST and not using HOST in 25-35 years group. However, cycles employing HOST showed significantly higher pregnancy rate (p = 0.023), clinical pregnancy rate (p = 0.005), and live birth rate (p = 0.045) as compared to cycles not using HOST, in the 36-40 years group. Conclusion:With normal semen parameters, the use of HOST in ICSI-Frozen ET cycles does not increase live birth rates in women aged 25-35, while it increases the rate of live births in women aged 36-40.

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  • [1] Practice Committee of the American Society for Reproductive Medicine, Practice Committee of the Society for Assisted Reproductive Technology. Genetic considerations related to intracytoplasmic sperm injection (ICSI). Fertil Steril 2006;86:103–105.
  • [2] Guzick DS, Overstreet JW, Factor-Litvak P, Brazil CK, Nakajima ST, Coutifaris C. Sperm morphology, motility, and concentration in fertile and infertile men. N Engl J Med 2001;345:1388–1393.
  • [3] Tournaye H, Verheyen G, Albano C, Camus M, Van Landuyt L, Devroey P. Intracytoplasmic sperm injection versus in vitro fertilization: a randomized controlled trial and a meta-analysis of the literature. Fertil Steril 2002; 78:1030–1037.
  • [4] Zini A, Jamal W, Cowan L, Al-Hathal N. Is sperm DNA damage associated with IVF embryo quality? A systematic review. J Assist Reprod Genet. 2011; 28(5): 391-397.
  • [5] Tesarik J, Greco E, Mendoza C. Late, but not early, paternal effect on human embryo development is related to sperm DNA fragmentation. Hum Reprod. 2004; 19(3):611-615.
  • [6] Barroso G, Valdespin C, Vega E, Kershenovich R, Avila R, Avendaño C. Developmental sperm contributions: fertilization and beyond. Fertil Steril. 2009; 92(3): 835-848.
  • [7] Nasr-Esfahani MH, Razavi S, Vahdati AA, Fathi F, Tavalaee M. Evaluation of sperm selection procedure based on hyaluronic acid binding ability on ICSI outcome. J Assist Reprod Genet 2008;25:197–203.
  • [8] Avendan˜o C, Franchi A, Taylor S, Morshedi M, Bocca S, Oehninger S. Fragmentation of DNA in morphologically normal human spermatozoa. Fertil Steril 2009;91:1077–1084.
  • [9] Zini A, Fischer MA, Sharir S, Shayegan B, Phang D, Jarvi K. Prevalence of abnormal sperm DNA denaturation in fertile and infertile men. Urology. 2002;60(6):1069–1072.
  • [10] [Belloc S, Hazout A, Zini A, Merviel P, Cabry R, Chahine H, Copin H, Benkhalifa M. How to overcome male infertility after 40: Influence of paternal age on fertility. Maturitas. 2014;78(1):22–29.
  • [11] Said TM, Land JA. Effects of advanced selection methods on sperm quality and ART outcome: a systematic review. Hum Reprod Update 2011;17:719–733.
  • [12] Mladenovic I, Micic S, Genbacev O. Hypoosmotic swelling test for quality control of sperm prepared for assisted reproduction. Arch Androl 1995;34:163-169.
  • [13] Stanger JD, Vo L, Yovich JL, Almahbobi G. Hypo-osmotic swelling test identifies individual spermatozoa with minimal DNA fragmentation. Reprod Biomed Online 2010;21:474–484.
  • [14] Jeyendran RS, Van der Ven HH, Perez-Pelaez M, Crabo BG, Zaneveld LJ. Development of an assay to assess the functional integrity of the human sperm membrane and its relationship to other semen characteristics. J ReprodFertil.1984; 70(1): 219-228.
  • [15] World Health Organization. Examination and Processing Human Semen, 5th ed. New York: Cambridge University Press; 2010.
  • [16] Tartagni M, Cicinelli E, Schonauer MM. Males with subnormal hypo-osmotic swelling test scores have lower pregnancy rates than those with normal scores when ovulation induction and timed intercourse is used as a treatment for mild problems with sperm count, motility, or morphology. J Androl 2004;25:781-783.
  • [17] Ramu S, Jeyendran RS. The hypo-osmotic swelling test for evaluation of sperm membrane integrity. Methods Mol Biol 2013;927:21-25.
  • [18] Buckett WM. Predictive value of hypo-osmotic swelling test to identify viable non-motile sperm. Asian J Androl 2003;5:209–212.
  • [19] El-Nour AM, Al Mayman HA, Jaroudi KA, Coskun S. Effects of the hypo-osmotic swelling test on the outcome of intracytoplasmic sperm injection for patients with only nonmotile spermatozoa available for injection: A prospective randomized trial. Fertility and Sterility, 2001; 75(3): 480–484.
  • [20] Sallam HN, Farrag A, Agameya AF, El-Garem Y, Ezzeldin F. The use of the modified hypo-osmotic swelling test for the selection of immotile testicular spermatozoa in patients treated with ICSI: A randomized controlled study. Human Reproduction, 2005; 20(12): 3435–3440.
  • [21] Alpha Scientists in Reproductive Medicine, ESHRE Special Interest Group Embryology. Istanbul consensus workshop on embryo assessment: proceedings of an expert meeting. Reprod Biomed Online 2011; 22:632–646.
  • [22] Henkel R, Schill WB. Sperm preparation for ART. Reprod Biol Endocrinol 2003;1:108.
  • [23] Tavalaee M, Razavi S, Nasr-Esfahani MH. Influence of sperm chromatin anomalies on assisted reproductive technology outcome. Fertil Steril 2009;91:1119–1126.
  • [24] Cincik M, Ergur AR, Tutuncu L, Muhcu M, Kilic M, Balaban B. Combination of hypoosmotic swelling/eosin Y test for sperm membrane integrity evaluation: correlations with other sperm parameters to predict ICSI cycles. Arch Androl. 2007; 53(1): 25-28.
  • [25] Rossato M, Galeazzi C, Ferigo M, Foresta C. Antisperm antibodies modify plasma membrane functional integrity and inhibit osmosensitive calcium influx in human sperm. Hum Reprod. 2004; 19(8): 1816-1820.
  • [26] Peris S, Solanes D, Pen˜a A, Enric-Rodrı´guez-Gil J, Riga T. Ionmediated resistance to osmotic changes of ram spermatozoa: the role of amiloride and ouabain. Theriogenology 2000;54:1453–1467.
  • [27] Avendan˜o C, Oehninger S. DNA fragmentation in morphologically normal spermatozoa: how much should we be concerned in the ICSI era? J Androl 2011;32:356–363.
  • [28] Bassiri F, Tavalaee M, Shiravi AH, Mansouri S, Nasr-Esfahani MH. Is there an association between HOST grades and sperm quality? Human Reproduction 2012; 27(8): 2277–2284.
  • [29] Bhattacharya SM. Hypo-osmotic swelling test and unexplained repeat early pregnancy loss. J Obstet Gynaecol Res 2010;36:119–122.
  • [30] Check M, Check JH, Summers-Chase D, Swenson K, Yuan W. An evaluation of the efficacy of in vitro fertilization with intracytoplasmic sperm injection for sperm with low hypoosmotic swelling test scores and poor morphology. J Assist Reprod Genet. 2003; 20(5): 182-185.