Beyond IUI, IVF and ICSI - New developments in - eshre 2013
Beyond IUI, IVF and ICSI - New developments in - eshre 2013
Beyond IUI, IVF and ICSI - New developments in - eshre 2013
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5. Birefr<strong>in</strong>gence–polarisation microscopy<br />
Partial sperm head birefr<strong>in</strong>gence<br />
Indicates acrosome reaction<br />
Higher cl<strong>in</strong> PR <strong>and</strong> IR compared with non-reacted sperm<br />
Gianaroli et al. 2010<br />
No comparative p studies available<br />
46% pregnancy rate<br />
Ghosh et al. 2012<br />
Limited cl<strong>in</strong>ical application<br />
Promis<strong>in</strong>g but expensive<br />
Not well-known<br />
<strong>ICSI</strong> with immotile sperm<br />
First pregnancy reported <strong>in</strong> 1997<br />
Kahraman et al. 1997<br />
Literature reports large ranges<br />
Fertilization rate: range 3% - 76.4%<br />
Pregnancy rate: range 0% - 38%<br />
Large series reported<br />
Kovacic et al. 2006<br />
47 cycles with immotile testicular sperm<br />
66% fertilization rate<br />
38.3% pregnancy rate<br />
<strong>ICSI</strong> with immotile sperm<br />
Discrepancies <strong>in</strong> literature may be caused by<br />
Overall time/effort spend for search<strong>in</strong>g motile sperm<br />
Real immotility vs virtual immotility of <strong>in</strong>dividual spermatozoa<br />
Accurate observation of <strong>in</strong>dividual sperm<br />
Choice of the technique to select viable sperm<br />
EExpertise i of f the h embryologist b l i with i h each h of f the h techniques h i<br />
Ejaculated sperm versus testicular sperm<br />
Search/observation time <br />
<br />
Real immotility <br />
<br />
Fertilization rate <br />
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