تاثير معايير النطف ونضوج مادة الصبغين على نتائج عملية الحقن المجهري == Impact of Sperm Parameters And Sperm Chromatin Maturity On Intracytoplasmic Sperm Injection Outcome
Author name:
هند عبد الكاظم
Supervisor name:
يحيى كاظم السلطاني
General topic:
Medicine
Specific topic:
Physiology
Degree:
Doctorate
University:
University of Kufa - Faculty Of Medicine - Department Of Physiology And Medical Physics
Language:
English
University location:
Najaf
First pages:
19T1124 - p.pdf
Abstract:
يعتبر العقم من المشاكل المتعلقة بصحة الانسان ويؤثرعلى سدس الازواج في عمر الانجاب تقريبا. يعد الذكر مسؤلا عن خمسين بالمئه من مجموع الحالات.الوظيفه الرئيسيه لتقنيات الانجاب المعان هي علاج العقم بما فيها حالات العقم الذكري وزيادة فرص الحمل من خلال التغلب عل | Infertility is a health concern affecting nearly 17% of young couples in their reproductive age. Male factor infertility accounts for 50% of all cases. The key responsibility of assisted reproductive technologies (ART) is the management of male infertility by bypassing seminal fluid disorders. Defective Sperm parameters were responsible for deciding the fertility potential and related to pregnancy rate in vivo as well as in vitro.Today, the classic seminal fluid analysis is found to be of limited importance in describing a couple’s fertility status. There is now clinical evidence to show that damage to human sperm DNA may adversely affect reproductive outcomes and the spermatozoa of infertile men possess substantially more DNA damage than do spermatozoa of fertile men and there appears to be a threshold of sperm DNA damage beyond which embryo development and pregnancy are impaired.In view of that, the aims of the present study were : Evaluation of the influence of defective sperm parameters including concentration, morphology and motility on intracytoplasmic sperm injection (ICSI) outcome represented by fertilization rate, cleavage rate, embryo quality and pregnancy rate. Assessment of the sperm chromatin maturity in infertile men using acidic aniline blue stain and compare it with that of men with normal spermiogram. Discovering the relationship between sperm chromatin status and the semen parameters in infertile males. Finding the relationship between sperm chromatin status and ICSI outcome.This study included 60 infertile couples complaining from either primary or secondary infertility attended the clinics of infertility treatment center and underwent intracytoplasmic sperm injection.They were classified according to their spermiogram to normozoospermic group (N), whose female partner had bilateral tubal block, oligoasthenoteratozoospermic group (OAT) and finally, asthenoteratozoospermic group (AT). The female partners of the last two groups had normal reproductive function according to gynecological examination and laboratory investigations. All female partners included in this study were less than 35 years old to minimize the influence of advanced maternal age on ICSI outcome. Seminal fluid analysis were done for all and aniline blue stain was used in this study to evaluate sperm chromatin integrity. The main results of this study showed that infertile couples with impaired sperm parameters show high percentage of positive aniline blue stain i.e., sperm chromatin maturity defect and it is significantly higher than that in couples with normal spermiogram. The best cut off point of positive chromatin percentage associated with pregnancy was 40% i.e., when sperm chromatin abnormality exceeds 40% as detected by aniline blue staining method; the pregnancy rate start to regress. No significant differences in fertilization rate, cleavage rate, embryo quality and pregnancy rate were found among studied groups.No significant difference in ICSI outcome including pregnancy rate between couples with high percentage of sperm chromatin damage ?30% and those with low percentage of sperm chromatin damage < 30% were found. So the main conclusions are : Defective sperm parameters and chromatin immaturity are significantly associated with each other.Forty percent is the threshold of sperm chromatin immaturity after which ICSI outcome deteriorate and depending 30% as a threshold in this study revealed no significant difference in ICSI outcome among studied groups. Intracytoplasmic sperm injection has corrective and therapeutic role for defective sperm parameters and shows a unique capability to treat the most difficult cases of male infertility.
