Morphological nuclear integrity of sperm cells is associated with preimplantation genetic aneuploidy screening cycle outcomes

Abstract

Objective: To examine the effect of sperm morphology on embryo development at the chromosomal level.

Design: Prospective study.

Setting: Assisted fertilization center.

Patient(s): Couples who underwent IVF-PGS cycle, as a result of advanced maternal age, were randomly allocated into two groups: intracytoplasmic sperm injection (ICSI; n = 60) or intracytoplasmic morphologically selected sperm injection (IMSI; n = 60).

Intervention(s): IVF in conjunction with preimplantation genetic screening (PGS).

Main outcome measure(s): Sperm nuclear morphology at high-magnification ICSI and incidence of aneuploidy in derived embryo.

Result(s): There was a significantly increased incidence for sex chromosome aneuploidy in ICSI embryos when compared with IMSI embryos (23.5% vs. 15.0%, respectively). High-magnification sperm selection was associated with a significantly lower risk of sex chromosome abnormalities (odds ratio [OR], 0.57; confidence interval [CI], 0.37-0.90). The incidence of chaotic embryos was also significantly higher with the ICSI procedure (27.5% vs. 18.8%), while the IMSI procedure was associated with a significantly lower risk of chaotic embryos (OR, 0.64; CI, 0.43-0.96). Moreover, the cycle cancellation rate was significantly higher in ICSI cycles (11.8% vs. 2.5%). High-magnification sperm selection was a significant predictor of the likelihood of cycle cancellation (OR, 0.26; CI, 0.11-0.62).

Conclusion(s): Spermatozoa free of nuclear morphological malformations were found to be significantly associated with the lower incidence of aneuploidy in derived embryos, resulting in lower rates of cycle cancellation.