Do patients presenting with flagella ultrastructural defects as assessed by electron microscopy, and defined within three phenotypes (dysplasia of the fibrous sheath [DFS], primary flagellar dyskinesia [PFD] and non-specific flagellar abnormalities [NSFA]), have decreased chances of success in intracytoplasmic sperm injection (ICSI) or adverse obstetric and neonatal outcomes?
Retrospective analysis of 189 ICSI cycles from 80 men with spermatozoa flagellum ultrastructural defects (DFS [n = 16]; PFD [n = 14]; NSFA [n = 50] compared with a control group (n = 97). Cycles were cumulatively analysed. All fresh and frozen embryo transfers resulting from each ICSI attempt were included. The effect of transmission electron microscopy (TEM) phenotype on the main ICSI outcomes was assessed by a multivariate logistic regression combined with a generalized linear mixed model to account for the non-independence of the observations.
No predictive value of TEM phenotype was found on the main outcomes of ICSI, namely fertilization rates, pregnancy and delivery rates, and cumulative pregnancy and delivery rates. Cumulative pregnancy rates ranged from 29.0-43.3% in the different TEM phenotype subgroups compared with 36.8% in the control group. Cumulative live birth rates ranged from 24.6-36.7% compared with 31.4% in the control group. No increase was found in miscarriages, preterm births, low birth weights or birth abnormalities.
Data on the cumulative chances of success in ICSI of patients with ultrastructural flagellar defects, a rare cause of male infertility often associated with an underlying genetic cause, are reassuring, as are obstetrical and neonatal outcomes in this population.
Reproductive biomedicine online. 2023 Aug 07 [Epub ahead of print]
Angèle Boursier, Augustin Boudry, Valérie Mitchell, Anne Loyens, Nathalie Rives, Alexandre Moerman, Lucie Thomas, Estelle Escudier, Aminata Toure, Marjorie Whitfield, Charles Coutton, Guillaume Martinez, Pierre F Ray, Zine-Eddine Kherraf, Stéphane Viville, Marie Legendre, Thomas Smol, Geoffroy Robin, Anne-Laure Barbotin
CHU Lille, Institut de Biologie de la Reproduction-Spermiologie-CECOS, F-59000, Lille, France; Inserm UMR-S 1172, Laboratory of Development and Plasticity of the Neuroendocrine Brain, Lille, France., CHU Lille, Centre de Biologie-Pathologie, Laboratoire d'hématologie, F-59000, Lille, France; Univ. Lille, CHU Lille, ULR 2694 - METRICS: Évaluation des technologies de santé et des pratiques médicales, Lille, France., CHU Lille, Institut de Biologie de la Reproduction-Spermiologie-CECOS, F-59000, Lille, France., Inserm UMR-S 1172, Laboratory of Development and Plasticity of the Neuroendocrine Brain, Lille, France., Normandie Univ, UNIROUEN, Inserm U1239 Team "Adrenal and Gonadal Physiopathology"., CHU Lille, Service de Génétique Clinique, Institut de Génétique Médicale, Hôpital Jeanne de Flandre, Lille, France., Sorbonne Université, Institut National de la Santé et de la Recherche Médicale, Childhood Genetic Disorders, Département de Génétique Médicale, Assistance Publique - Hôpitaux de Paris, Hôpital Trousseau, Paris 75012, France., Genetic Epigenetic and Therapies of Infertility, Institute for Advanced Biosciences, INSERM U1209, CNRS UMR5309, Université Grenoble Alpes, 38000 Grenoble, France., Genetic Epigenetic and Therapies of Infertility, Institute for Advanced Biosciences, INSERM U1209, CNRS UMR5309, Université Grenoble Alpes, 38000 Grenoble, France; UM de Génétique Chromosomique, Hôpital Couple-Enfant, Centre Hospitalier Universitaire de Grenoble, 38000 Grenoble, France., Genetic Epigenetic and Therapies of Infertility, Institute for Advanced Biosciences, INSERM U1209, CNRS UMR5309, Université Grenoble Alpes, 38000 Grenoble, France; UM GI-DPI, Centre Hospitalier Universitaire de Grenoble, 38000 Grenoble, France., Laboratoire de Génétique Médicale LGM, Institut de Génétique Médicale d'Alsace IGMA, INSERM UMR 1112, Université de Strasbourg, Strasbourg, France; Laboratoire de Diagnostic Génétique, Unité de Génétique de l'Infertilité (UF3472), Hôpitaux Universitaires de Strasbourg, Strasbourg, France., CHU Lille, Service de Génétique Clinique, Institut de Génétique Médicale, Hôpital Jeanne de Flandre, Lille, France; Université de Lille, EA 7364-RADEME, Lille, France., Université de Lille, CHU Lille, Service de Gynécologie Médicale Orthogénie et Sexologie, F-59000, Lille, France., CHU Lille, Institut de Biologie de la Reproduction-Spermiologie-CECOS, F-59000, Lille, France; Inserm UMR-S 1172, Laboratory of Development and Plasticity of the Neuroendocrine Brain, Lille, France. Electronic address: .