Vildan KARPUZ, Aslı GÖKTÜRK, Meral KOYUTÜRK

SPERM MORFOLOJİSİ VE MOTİLİTESİNİN İNTRASİTOPLAZMİK SPERM ENJEKSİYON SONUÇLARI ÜZERİNE ETKİLERİ

Amaç: İntrasitoplazmik sperm enjeksiyonu (ICSI) tedavi sonuçları, sperm morfoloji ve motilite sınıflandırmaları ile karşılaştırılarak değerlendirildi; bu çerçevede Kruger kesin kriterlerinin veya motilitenin, bu sonuçları tahminde yardımcı olup olamıyacağı araştırıldı. Yöntem: Kliniğe başvuran infertil çiftlerden, 242 si seçilerek ICSI tedavisi uygulandı. Çalışma grubundaki kadın partnerlerde Metafiz II oosit sayısı en az 5 ve üzerinde, erkek partnerlerde ise yanlızca semen sıvısında sperm bulunması gereği öngörüldü. Semen analizi ve motilite değerlendirmesi Dünya Sağlık Örgütü (WHO) kriterlerine göre gerçekleştirildi; sperm morfolojisi ise “Kruger’in kesin kriterleri”ne göre değerlendirildi. Bulgular: Sperm morfoloji ve motilite yüzdelerine göre oluşturulan gruplar içerisinde ICSI sonuçlarını değerlendirme parametrelerinden, fertilizasyon ve gebelik oranları arasında anlamlı bir fark saptanmadı. Sonuç: Sperm motilite ve morfolojisi in vitro fertilizasyon (IVF) sonuçlarının değerlendirilmesinde en iyi parametreler olarak kabul edilmektedir. Oysa ki bizim bulgularımız ICSI sonuçlarının IVF için değerli olan bu parametrelerden bağımsız olduğunu göstermektedir.Anahtar Kelimeler: Sperm morfolojisi, Sperm motilitesi, ICSI

Anahtar Kelimeler:

Sperm morfolojisi, Sperm motilitesi, ICSI

-

Keywords:

-,

PDF

___

1. Check JH, Bollendorf A, Pres M, Blue T. Standard sperm morphology as a predictor of male fertility potential. Arch Androl 1992; 28: 39-41.
2. Lundin K, Soderlund B, Hamberger L. The relationship between sperm morphology and rates of fertilization, pregnancy and spontaneous abortion in an in-vitro fertilization/intracytoplasmic sperm injection programme. Hum Reprod 1997; 12: 2676-81.
3. Bonde JP, Ernst E, Jensen TK, et al. Relation between semen quality and fertility: a population-based study of 430 first-pregnancy planners. Lancet 1998; 10: 1172-76.
4. Enginsu ME, Pieters MHEC, Dumoulin JCM, Evers JLH, Geraedts JPM. Male factor as determinant of in vitro fertilization outcome. Hum Reprod 1992; 7: 1136- 40.
5. Pacey AA. Is quality assurance in semen analysis still really necessary? A view from the andrology laboratory. Hum Reprod 2006; 21:1105-9.
6. Bartoov B, Eltes F, Pansky M, et al. Improved diagnosis of male fertility potential via a combination of quantitative ultramorphology and routine semen analyses. Hum Reprod 1994; 9: 2069-74.
7. Berkovitz A, Eltes F, Soffer Y, et al. ART succes and in vivo sperm cell selection depend on the ultramorphological status of spermatozoa. Andrologia 1999; 31: 1-8.
8. Mashiach R, Fisch B, Eltes F, et al. The relationship between sperm ultrastructural features and fertilizing capacity in vitro. Fertil Steril 1992; 57: 1052-57.
9. Kruger TF, Swanson RJ, Acosta AA, et al. Predictive value of abnormal sperm morphology in in vitro fertilization. Fertil Steril 1988; 49: 112-17.
10. World Health Organization. WHO laboratory manual for the examination of human semen and sperm-cervical mucus interaction, 4th edition. Cambrige University Press, Cambridge, 1999; 1-125.
11. Kruger TF, Menkveld R, Stander FrSH, et al. Sperm morphologic features a prognostic factor in in vitro fertilization. Fertil Steril 1986; 46: 1118-23.
12. Martinez C, Marc C, Azcarate M, Pascual P, Aritzeda JMA. Sperm motility index: a quick screening parameter from sperm quality analyser-IIB to rule out oligo- and astenozoospermia in male fertility study. Hum Reprod 2000; 15: 1727-33.
13. Svalander P, Jakobsson AH, Forsberg AS, Bengtsson AC, Wikland M. The outcome of intracytoplasmic sperm injection is unrelated to ‘strict criteria’ sperm morphology. Hum Reprod 1996; 11: 1019-22.
14. Lui J, Nagy Z, Tournaye H, et al. Analysis of 76 total fertilization failure cycles out of 2732 intracytoplasmic sperm injection cycles. Hum Reprod 1995; 10: 2630-36.
15. Vandervorst M, Tournaye H, Camus M, et al. Patients with absolutely immotile spermatozoa and intracytoplasmic sperm injection. Hum Reprod 1997; 12: 2429-33.
16. Nikolettos N, Kupker W, Demirel C, et al. Fertilization potential of spermatozoa with abnormal morphology. Hum Reprod 1999; 14: 47-70.
17. Evenson DP, Darzynkiewicz Z, Melamed MR. Relation of mammalian sperm chromatin heterogeneity to fertility. Science 1980; 210:1131-33.
18. Sakkas D, Urner F, Bianchi PG, et al. Sperm chromatin anomalies can influence decondensation after intracytoplasmic sperm injection. Hum Reprod 1996; 11: 837-43.
19. Tasdemir I, Tasdemir M, Tavukcuoglu S, Kahraman S, Biberoglu K. Effect of abnormal sperm head morphology on the outcome of intracytoplasmic sperm injection in humans. Hum Reprod 1997; 12: 1214-17.
20. Bostofte E, Serup J, Rebbe H. Relation between morphologically abnormal spermatozoa and pregnancies obtained during a twenty-year follow-up period. Int J Androl 1982; 5: 379-86.
21. Van Steirteghem AC, Nagy Z, Joris H, et al. High fertilization and implantation rates after intracytoplasmic sperm injection. Hum Reprod 1993; 8:1061-66.
22. Palermo G, Joris H, Devroey P, Van Steirteghem AC. Pregnancies after intracytoplasmic injection of single spermatozoon into an oocyte. Lancet 1992; 340:17-8.
23. Kahraman S, Akarsu C, Cengiz G, et al. Fertility of ejaculated and testicular megalohead spermatozoa with intracytoplasmic sperm injection. Hum Reprod 1999; 14: 726-30.
24. Bartoov B, Berkovitz A, Eltes F, et al. Real-time fine morphology of motile human sperm cells is associated with IVF-ICSI outcome. J Androl 2002; 23: 1-8.
25. Berkovitz A, Eltes F, Yari S, et al. The morphological normalcy of the sperm nucleus and pregnancy rate of intracytoplasmic injection with morphologically selected sperm. Hum Reprod 2005; 20: 185-90.
26. Calogero AE, De Palma A, Grazioza C, et al. High sperm aneuploidy rate in unselected infertile patients and its relationship with intracytoplasmic sperm injection outcome. Hum Reprod 2001; 16:1433-39.