No difference in high-magnification morphology and hyaluronic acid binding in the selection of euploid spermatozoa with intact DNA

In this study, we compared conventional sperm selection with high-magnification morphology based on the motile sperm organellar morphology examination （MSOME） criteria, and hyaluronic acid （HA） binding for sperm chromosome aneuploidy and DNA fragmentation rates. Semen from 50 severe male factor cases was processed through density gradient centrifugation, and subjected to sperm selection by using the conventional method （control）, high magnification at x6650 or HA binding. Aneuploidy was detected by fluorescence in situ hybridization with probes for chromosomes 13, 18, 21, X and Y, and DNA fragmentation by the terminal deoxynucleotidyl transferase dUTP nick end labelling （TUNEL） method. Spermatozoa selected under high-magnification had a lower DNA fragmentation rate （2.6% vs. 1.7%; P=0.032）, with no significant difference in aneuploidy rate （0.8% vs0.7%; P=0.583）, than those selected by the HA binding method. Spermatozoa selected by both methods had much lower aneuploidy and DNA fragmentation rate than the controls （7% aneuploidy and 26.8% DNA fragmentation rates, respectively）. In the high-magnification group, the aneuploidy rate was lower when the best spermatozoa were selected than when only the second-best spermatozoa were available for selection, but the DNA fragmentation rate was not different. In conclusion, sperm selection under high magnification was more effective than under HA binding in selecting spermatozoa with low DNA fragmentation rate, but the small difference （0.9%） might not be clinically meaningful. Both methods were better than the conventional method of sperm selection.

Is there a difference in cognitive development between preschool singletons and twins born after intracytoplasmic sperm injection or in vitro fertilization？

Objective： To explore whether there exist differences in cognitive development between singletons and twins born after in vitro fertilization （IVF） or intracytoplasmic sperm injection （ICSI）. Methods： A total of 566 children were recruited for the study, including 388 children （singletons, n=175; twins, n=213） born after IVF and 178 children （singletons, n=87; twins, n=91 ） born after ICSI. The cognitive development was assessed using the Chinese-Wechsler Intelligence Scale for Children （C-WISC）. Results： For all pre-term offspring, all the intelligence quotient （IQ） items between singletons and twins showed no significant differences no matter if they were born after IVF or ICSI. There was a significant difference in the cognitive development of IVF-conceived full-term singletons and twins. The twins born after IVF obtained significantly lower scores than the singletons in verbal IQ （containing information, picture ＆ vocabulary, arithmetic, picture completion, comprehension, and language）, performance IQ （containing maze, visual analysis, object assembly, and performance）, and full scale IQ （P〈0.05）. The cognitive development of full-term sin- gletons and twins born after ICSI did not show any significant differences. There was no significant difference between the parents of the singletons and twins in their characteristics where data were collected, including the age of the mothers, the current employment status, the educational backgrounds, and areas of residence. There were also no consistent differences in the duration of pregnancy, sex composition of the children, age, and height between sin- gletons and twins at the time of our study although there existed significant differences between the two groups in the sex composition of the full-term children born after ICSI （P〈0.05）. Conclusions： Compared to the full-term singletons born after IVF, the full-term twins have lower cognitive development. The cognitive development of full-term singletons and twins born after ICSI did not show any significant differences. For all pre-term offspring, singletons and twins born after IVF or ICSI, the results of the cognitive development showed no significant differences.

Sperm DNA Fragmentation may Influence IUI Outcome but could be Treated by ICSI: Evidence from Human Sperm Bank

Objective To determine the correlation between semen parameters, sperm DNA damage, progressive motility （PR）, morphology and intrauterine insemination （IUI）/ intracyto- plasmic sperm injection （ICSI） outcomes. Methods All the donors providing the samples in this study were recruited by Shang- hai Human Sperm Bank. For IUI, 122 donors were divided into group A （n=60） and group B （n=62）. Group A had a higher pregnancy rate while group B had a lower pregnancy rate （3.86 ± 1.50% vs 0.18 ± 0.52%）. For ICSI, 45 donors were divided into group C with a higher pregnancy rate （77. 78 ± 17.21%, n=23）, group D with a lower pregnancy rate （40. 73 ± 19.19%, n=22） and group E with an average preg- nancy rate in the sperm bank （48.96 ± 12.08%, n=23）. Semen analysis, morphology and DNA damage were assessed on samples retained in the sperm bank. Fresh semen samples were also collected and corresponding semen analyses data was included along with the pregnancy rates. Results No significant difference was found in the population characteristics between groups A and B, while there was a significant difference in sperm DNA fragmetation index （DFI） and morphology between the two groups （P〈0.05）, but not in other semen parameters （P〉0.05）. There was no significant difference in population characteristics between groups C, D and E while the DFI of group D was significant higher than groups C and E （P〈0.01）, but there was no significant difference in other semen parameters （P〉0.05）.Conclusion DFI might be a good predictor for IUI outcomes. Infertile couples with a high DFI should choose ICSI treatment instead of IUI. DFI should be a routine screening marker used to screen for sperm donors.