Hatice AKTAŞ, Bulat Aytek ŞIK, Arzu Yılda ABA

AĞIR TERATOSPERMİYE BAĞLI ERKEK İNFERTİLİTESİNDE İNTRASİTOPLAZMİK SPERM ENJEKSİYONU-EMBRİYO TRANSFERİ SONRASI GEBELİK SONUÇLARININ DEĞERLENDİRİLMESİ

AMAÇ: Normal sperm morfolojisi %0 olan erkek infertilitesine sahip hastalarla normal sperm morfolojisi %1 - 4 olan erkek infertilitesine sahip hastaların, intrastoplazmik sperm enjeksiyonu (ICSI) - embriyo transferi (ET) sonrası gebelik sonuçları bakımından karşılaştırılması amaçlanmıştır.GEREÇ VE YÖNTEM: Erkek infertilitesinde önemli bir yer tutan ağır teratozoosperminin ICSI sonuçları üzerine etkisi araştırılmıştır. Kruger strict kriterlerine göre spermiyogramda normal morfoloji oranı %0 olan hastalar ile %1 - 4 olan hasta hastalar, elde edilen MII oosit sayısı, fertilize oosit sayısı, transfer edilen embriyo sayısı, implante olan embriyo sayısı, fertilizasyon oranı ve klinik gebelik oranları bakımından karşılaştırıldı. Gruplar arası dengeyi sağlamak amacı ile 38 yaş üstü, düşük over rezervine sahip, polikistik over sendromu olan kadın hastalar ile azospermisi olan veya total immotil sperm tanısı almış erkek hastalar çalışmaya dahil edilmedi.BULGULAR: İki hasta grubu arasında; ortalama yaş, ortalama infertilite süresi, ortalama vücut kitle indeksi, infertilite tipi, infertilite nedeni, sigara içiciliği, alkol kullanımı, erkek hastalarda geçirilmiş cerrahi, bazal hormon seviyeleri ve antral folikül sayısı bakımından istatistiksel olarak anlamlı bir fark yoktu (p>0,05). İki grupta elde edilen total oosit sayısı, MII oosit sayısı, fertilize oosit sayısı, fertilizasyon oranı ve transfer edilen embriyo sayısı açısından da istatistiksel olarak anlamlı derecede bir fark bulunamamıştır. Morfoloji %0 ve Morfoloji %1 - 4 gruplarının gebelik sonuçları arasında istatistiksel farklılık gözlenmemiştir (p=0,824), (p=0,854), (p=0.216), (p=0,812).SONUÇ: Sperm morfolojisinin, ICSI-ET sikluslarında, fertilizasyon oranları, klinik gebelik oranları ve canlı doğum oranlarına etkisi gözlenmemiştir.

Anahtar Kelimeler:

İntrastoplazmik Sperm Enjeksiyonu, Sperm morfolojisi, Erkek İnfertilitesi

EVALUATION OF PREGNANCY RESULTS AFTER INTRACYTOPLASMIC SPERM INJECTION-EMBRYO TRANSFER IN MALE INFERTILITY DUE TO SEVERE TERATOZOOSPERMIA

OBJECTIVE: It was aimed to compare the results of pregnancy after intracytoplasmic sperm injection (ICSI) embryo transfer of the patient group with male sperm infertility with 0% normal sperm morphology and 1 - 4% male sperm with normal sperm morphology.MATERIAL AND METHODS: We investigated the effect of heavy teratozoospermia, which has an important place in male infertility, on ICSI results. According to Kruger strict criteria, patients with a normal morphology rate of 0% and patients with 1 - 4% in the spermiogram were compared in terms of the number of MII oocytes obtained, the number of fertilized oocytes, the number of embryos transferred, the number of implanted embryos, the fertilization rate and clinical pregnancy rates. We did not include female patients over 38 years of age, with low ovarian reserve, polycystic ovarian structure, and male patients with azoospermia or diagnosed with total immotile sperm in order to achieve a balance between the groups.RESULTS: There were no statistically significant differences between the groups in terms of mean age, mean infertility duration, mean Body Mass Index (BMI), type of infertility, cause of infertility, smoking, alcohol use, previous surgery in male patients, basal hormone levels, and basal ovarian grade(p>0.05). When we compare the total oocyte count, MII oocyte count, fertilized oocyte count, fertilization rate, the number of embryos transferred in the two groups, there was no statistically significant difference between the pregnancy outcomes of morphology 0% and morphology 1-4% groups (p = 0.824), (p = 0.854), (p = 0.216), (p = 0.812).CONCLUSIONS: No effect of sperm morphology on fertilization rates, clinical pregnancy rates, and live birth rates was observed in intracytoplasmic sperm injection-embryo transfer cycles (ICSI-ET).

Keywords:

Intracytoplasmic Sperm Injection, Sperm Morphology, Male infertility,

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