Erkek infertilitesinde sperm seçim yöntemlerinin yardımcı üreme sonuçları üzerine etkilerinin karşılaştırılması

Amaç: Şiddetli veya orta derecede oligoastenospermi olgularında fizyolojik intrasitoplazmik sperm enjeksiyonu (PICSI) ve hipoosmotik şişme testi (HOST) sperm seçim tekniklerini, embriyo gelişimi, implantasyon oranı ve canlı doğum oranları açısından karşılaştırmak. Gereç ve yöntemler: Medipol Üniversitesi Tüp Bebek Merkezi'ne 2013-2022 yılları arasında başvuran olguların elektronik materyalleri ve dosyaları retrospektif olarak analiz edildi. Ağır veya orta derecede oligoastenospermi tanısı konulan toplam 143 olgu çalışmaya dahil edildi, 80 olguda sperm seçim tekniği olarak PICSI ve 63 olguda sperm seçim tekniği olarak HOST kullanıldı. Dünya Sağlık Örgütü (WHO) tarafından tanımlanan şiddetli veya orta derecede oligoastenospermi vakaları bu çalışmaya dahil edildi. Kadın yaşı, erkek yaşı, infertilite süresi, AMH (anti-Mullerian hormon), vücut kitle indeksi (VKİ), endometrial kalınlık ve önceki deneme sayısı dahil olmak üzere her iki grubun demografik parametreleri ve implantasyon, gebelik kaybı ve canlı doğum oranları olmak üzere transfer sonuçları iki grup arasında karşılaştırıldı. Bulgular: Kadın yaşı, erkek yaşı, vücut kitle indeksi, AMH, endometrial kalınlık ve önceki deneme sayısı çalışmaya dahil edilen gruplar arasında benzerdi. Gruplar arasında fertilizasyon (.18±6.92 vs 9.11±6.35, p=0.345), TQ-GQ blastokist gelişimi (2.36±2.40 vs 1.64±2.35, p=0.097) ve transfer edilen embriyo sayısı (1.59±0.50 -1.76±0.44 p= 0.141) açısından anlamlı fark yoktu. PICSI ve HOST grupları arasında canlı doğum oranı (p= 0.790) arasında fak olmamasına rağmen HOST grubunda implantasyon oranı PICSI grubuna göre anlamlı olarak daha yüksekti (p=0.043). PICSI veya HOST yöntemiyle sperm seçimi yapılmasının döllenme, TQ-GQ blastokist gelişimi, gebelik kaybı oranları ve canlı doğum oranlarını etkilemediği görüldü. Sonuç: İki yöntem arasında embriyo gelişimi, gebelik kaybı ve canlı doğum oranları açısından fark bulunamadı, ancak HOST grubunda implantasyon oranı daha yüksek bulundu.

Anahtar Kelimeler:

PICSI, HOST, Erkek infetilitesi

Comparison of the effects of sperm selection methods on assisted reproduction outcomes in male infertility

Objective: To compare physiological intracytoplasmic sperm injection (PICSI) and the hypoosmotic swelling test (HOST) sperm selection techniques in terms of embryo development, implantation rate and live birth rates in cases of severe or moderate oligoastheneospermia. Materials and Methods: The electronic material and files of cases admitted to the Medipol University IVF Centre between 2013 and 2022 were analyzed retrospectively. This research included a total of 143 cases with moderate or severe oligoasthenospermia, 80 cases with PICSI as sperm selection technique and 63 cases with HOST as sperm selection technique. Cases of severe or moderate oligoasthenospermia as defined by the World Health Organisation (WHO) are included in this study. The demographic parameters of both groups, including female age, paternal age, duration of infertility, AMH (anti-Mullerian hormone), body mass index (BMI), endometrial thickness, and the number of prior attempts, were analyzed. Implantation, pregnancy loss, and rates of live births were compared between two groups. Results: Female age, paternal age, AMH, endometrial thickness, BMI, and the number of previous trials were similar between the groups included in the study. There were not any significant differences between the groups in terms of fertilization (.18±6.92 vs 9.11±6.35, p=0.345), TQ-GQ blastocyst development (2.36±2.40 vs 1.64±2.35, p=0.097), and the number of embryos transferred (1.59±0.50 -1.76±0.44 p= 0.141). The live birth rates between the PICSI and HOST groups did not vary statistically (p=0.790), however, the rate of implantation was significantly higher in the HOST group (p=0.043). Sperm selection by PICSI or HOST method did not affect fertilization, TQ-GQ blastocyst development, and the rates of pregnancy loss and live birth. Conclusion: Although there were not any differences in embryo development, pregnancy loss, and live birth rates comparing the two methods, the HOST group had a higher implantation rate.

Keywords:

PICSI HOST, Male infertlity, live birth,

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