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Hum. Reprod. Advance Access originally published online on December 14, 2007
Human Reproduction 2008 23(2):240-250; doi:10.1093/humrep/dem395
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© The Author 2007. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

The role of sperm aneuploidy as a predictor of the success of intracytoplasmic sperm injection?

J.D.M. Nicopoullos1,6, C. Gilling-Smith1, P.A. Almeida1, S. Homa2, L. Nice3, H. Tempest4 and J.W.A. Ramsay1,5

1 Assisted Conception Unit, Chelsea and Westminster Hospital, London SW10 9NH, UK 2 Department of Andrology, The Doctors Laboratory, London W1T 4EU, UK 3 BMI Chiltern, Lakeside Suite, Buckinghamshire HP16 OEN, UK 4 Department of Medical Genetics, University of Calgary, Alberta, T2N 4NI, Canada 5 Hammersmith Hospitals NHS Trust, London W6 8RF, UK

6 Correspondence address. E-mail: jnicopoullos{at}aol.com

BACKGROUND: We present the first powered prospective study to assess whether sperm aneuploidy can predict the outcome of ICSI.

METHODS: Our null hypothesis was that aneuploidy rates (AR) are identical in men who achieve successful (Group A) and unsuccessful (Group B) ICSI outcome. A power calculation yielded a sample number of 56 to achieve 80% power to reject our hypothesis at the 5% significance level. Samples for testing were obtained on the day of embryo transfer and tests were performed on raw pre-preparation samples. Sperm AR of chromosomes 13, 18, 21, X/Y were assessed using fluorescence in-situ hybridization (FISH) techniques (mean of 1223 sperm).

RESULTS: There was no significant difference in any patient, seminal, cycle or laboratory characteristic between groups that may have affected outcome. Total AR (2.37 versus 1.18%, P = 0.01), as well as AR of chromosomes 18, X/Y and 18 + X/Y (1.48 versus 0.67%, P = 0.005) were significantly higher in Group B compared with Group A. Regression analysis confirmed these differences to be independent of other variables and showed a 2.6-fold change in odds of achieving a pregnancy for every 1% change in total AR.

CONCLUSIONS: Our findings confirm a potential role for aneuploidy testing in the work-up of ICSI patients as a predictor of success, as well as in future genetic counselling. If confirmed, there may also be a place for a study of preimplantation genetic screening to improve ICSI success in men found to have high AR and ICSI failure.

Key words: ART outcome/intracytoplasmic sperm injection/male infertility/sperm aneuploidy

Submitted on September 16, 2007; resubmitted on October 27, 2007; accepted on November 2, 2007.


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