Low birth defects by deselecting abnormal spermatozoa before ICSI

REPRODUCTIVE BIOMEDICINE ONLINE

卷:28

Article

Cassuto, Nino Guy¹  Hazout, Andre¹  Bouret, Dominique¹  Balet, Richard²  Larue, Lionel³  Benifla, Jean Louis⁴  Viot, Geraldine⁵ 

[1] Drouot Lab, Art Unit, F-75009 Paris, France

[2] Bleuets Hosp, F-75012 Paris, France

[3] Diaconesses St Simon Hosp, F-75012 Paris, France

[4] Trousseau Hosp, F-70012 Paris, France

[5] Cochin Hosp, F-75014 Paris, France

关键词: birth defects;    high magnification;    ICSI;    IMSI;    sperm head;   

DOI  :  10.1016/j.rbmo.2013.08.013

来源: Elsevier

【 摘 要 】

Consistent evidence from meta-analysis has linked assisted conception by IVF, and particularly intracytoplasmic sperm injection (ICSI), with an increased risk of major birth defects. To compare the risk of major malformations of children born after standard ICSI and after intracytoplasmic injection of morphologically selected spermatozoa (IMSI), a prospective population-based study was conducted from 2005 to 2010. ICSI and IMSI were performed in only one assisted reproduction unit according to its classification of spermatozoa and using fresh semen. Medical data and follow up during 2 years of 1028 infants were collected. Major malformations were identified and classified by an external independent physician. The two groups were similar concerning the parents' age, treatment, number of oocytes recovered, days of transfer, gestational age and birthweight. However, major malformations were significantly lower with IMSI (6/450, 1.33%) versus ICSI (22/578, 3.80%; adjusted odds ratio 0.35, 95% confidence interval 0.14-0.87, P = 0.014), mainly affecting boys (adjusted odds ratio 2.84, 95% confidence interval 1.24-6.53, P = 0.009). In conclusion, the significantly decreased risk of major birth defects associated with IMSI remained decreased after multivariate adjustment and highlights the beneficial effect of sperm selection before ICSI. (C) 2013, Reproductive Healthcare Ltd. Published by Elsevier Ltd. All rights reserved.

【 授权许可】

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