Андрология и генитальная хирургия (Sep 2022)
Sperm agglutination and ejaculate liquefaction time as negative prognostic factor in ICSI
Abstract
Background. Not all pathological mechanisms of fertility disorders in men are currently the correct diagnostic tests, this significantly reduces the prognostic value of the spermogram and makes the question of assessing spermogram character disorders and its impact on the effectiveness of assisted reproductive technologies (ART) procedures extremely relevant. In our study, we retrospectively evaluated the parameters of ejaculate and their effect on ART outcomes.Aim. To assess the effect of sperm agglutination and ejaculate liquefaction time on in vitro fertilization (IVF) with intracytoplasmic sperm injection (ICSI) results.Materials and methods. The selection of married couples was carried out on the basis of the V.I. Kulakov National Medical Research Center of Obstetrics, Gynecology and Perinatology of the Ministry of Health of Russia. The study included 6,416 married couples who sought IVF-ICSI in the period from December 2012 to December 2016. Ages of men varied between 23 and 74 years, ages of women between 17 and 53 years. Examination data of the patients were extracted from the BABE software. In the study, sperm analysis parameters were evaluated during preparation to the IVF program, IVF-ICSI, and on the day of transvaginal ovarian puncture. Using univariant and regression analysis, prognostic factors of clinical pregnancy and childbirth after IVF-ICSI were determined.Results. Sperm agglutination rates adversely affect the incidence of clinical pregnancy (probability ratio (PR) 0.701; 95 % confidence interval (CI) 0.589–0.834; p <0.001) and childbirth (PR 1.719; 95 % CI 1.220–2.422; p = 0.002) in IVF-ICSI assisted reproductive technologies. Ejaculate liquefaction has a negative effect on the incidence of clinical IVF-ICSI pregnancy (PR 0.967; 95 % CI 0.949–0.986; p = 0.001).Conclusion. Andrologists should seek to improve the above ejaculate parameters with various treatments to improve the effectiveness of ART programs.
Keywords