玻尿酸選擇精蟲可提高胚胎品質

這篇提出爭議已久老問題之結果:
HA(玻尿酸)對ICSI結果是可能有正面幫助，可提高胚胎品質‧

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2826621/

J Assist Reprod Genet. 2010 Jan;27(1):13-6. Epub 2009 Dec 30.

Efficiency of hyaluronic acid (HA) sperm selection.

Parmegiani L, Cognigni GE, Ciampaglia W, Pocognoli P, Marchi F, Filicori M.

Source

Reproductive Medicine Unit-GynePro Medical Centers, GynePro Medical, Via T. Cremona, 8-40137, Bologna, Italy. l.parmegiani@gynepro.it

Abstract

PURPOSE:

Hyaluronic Acid (HA) has a role as "physiologic selector" for spermatozoa prior to intracytoplasmic sperm injection (ICSI). The objective of this study is to analyze the results achievable by the introduction of a routine HA-ICSI programme.

METHODS:

We retrospectively observed 293 couples treated with HA-ICSI versus 86 couples treated with conventional PVP-ICSI (historical control group). ICSI was performed on a limited number of oocytes per patient (1-3) according to Italian IVF law at the time of the study. Main outcome measures observed were: fertilization, embryo quality, implantation and pregnancy.

RESULTS:

This study showed that Injection of HA-bound spermatozoa (HA-ICSI) significantly improves embryo quality and implantation.

CONCLUSIONS:

If wider multi-center randomized studies will confirm these beneficial effects on ICSI outcome, HA could be considered as a routine choice for "physiologic" sperm selection prior to ICSI.

Table 1

HA-ICSI versus conventional ICSI

	HA-ICSI	PVP-ICSI	P
Fertilized oocytes (%)	874/936 (93.4)	223/256 (87.1)	0.533
Grade 1 embryos (%)	274/778 (35.2)	48/215 (22.3)	0.011*
Clinical pregnancy rate per transfer (%)	107/326 (32.8)	21/96 (21.6)	0.158
Clinical pregnancy rate per cycle (%)	107/331 (32.3)	21/97 (21.6)	0.163
Implantations (%)	133/778 (17.1)	22/213 (10.3)	0.047*
Abortions (%)	19/107 (17.7)	3/21 (14.3)	0.990
No. Ectopic pregnancies	3	0
No. Gestational sacs without FHB	3	0
Live births (babies born)	53 (62)	18 (19)
Ongoing pregnancies	29	0

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Difference was considered significant when a P-value was <0.05

*P-value<0.05

For HA-ICSI: on a Petri dish, a 1 µL to 2 µL droplet with suspension of treated spermatozoa (concentration 1×10⁶) was connected with a pipette tip to a 5 µL droplet of fresh culture medium (FertiCult Flushing Medium, FertiPro NV, Beernem, Belgium). Simultaneously, a 5 µL droplet of HA-containing medium (Sperm Slow™, MediCult) was connected with a pipette tip to the droplet of fresh culture medium. The spermatozoa on this Petri dish were incubated for 15 min at 37°C under oil (Liquid Paraffin, MediCult). Spermatozoa bound to HA in the junction zone of the droplets were selected and easily detached by injecting pipette (ICSI Micropipets, Humagen Fertility Diagnostics) and subsequently injected into oocytes.