OUTCOMES OF ASSISTED REPRODUCTIVE TECHNOLOGY PROGRAMS IN MARRIED COUPLES WITH DIFFERENT TYPES OF PATHOZOOSPERMIA IN MEN


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Abstract

Background. Increased sperm chromosome aneuploidy may negatively affect the probability of conception in couples with different spermatogenic disorders. Objective. To study the efficiency of assisted reproductive technology (ART) programs in couples with different types of pathozoospermia (PZ) in relation to the rate of sperm chromosome aneuploidy. Subject and methods. The prospective cohort study enrolled 86 married couples treated for infertility in the ART programs, who were divided into three groups: 1) 26 patients with teratozoospermia (TZ); 2) 35 with asthenozoospermia and/or oligizoospermia; 3) 25 with normozoospermia (NZ). The number of sperm chromosomes X, Y, and 18 was estimated by fluorescence in situ hybridization. Ovarian function was stimulated using the uniform short protocol. The primary endpoint was an adjusted odds ratio (OR adj) of conception in relation to the rate of sperm chromosome aneuploidy. The secondary endpoints were the mean rate of sperm chromosome aneuploidy; the mean rate fertilization in the compared patient groups; the threshold level of aneuploidy in the sperm nuclei; a correlation between different spermogram parameters, as well as the rate of fertilization and that of sperm chromosome aneuploidy. Results. Sperm aneuploidy rates statistically significantly differed in the patient groups and were 0.93±0.61% in Group 1, 0.74±0.78% in Group 2, and 0.34±0.12% in Group 3 (p=0.0003). Negative correlations were found between the normal shapes of spermatozoa and the rate of aneuploidy (r=-0.21; p=0.047) and between the rate of sperm aneuploidy and that of fertilization (r=-0.31; p = 0.0035). The ART protocols showed the same number of embryos in the 3 patient groups. Two embryos of equal quality were transferred in each cycle. Twenty-four pregnancies were clinically diagnosed: 4 (15.4%) in Group 1, 8 (22.8%) in Group 2, and 12 (48%) in Group 3 (p=0.0237). OR adj was 4.51 (95% CI=1.09; 18.68). Analysis of the ROC curve of 0.63 determined the threshold value of aneuploidy in the sperm nuclei in relation to the efficiency of ART program, which was 0.7%. Conclusion. Male PZ, TZ in particular, contributes to the increased risk of failures of ART programs. One of these outcomes may be elevated sperm chromosome aneuploidy. Molecular cytogenetic study of ejaculates from men with PZ should be recommended for married couples treated using the in vitro fertilization (IVF)/intracytoplasmic sperm injection technique to make a decision on preimplantation genetic diagnosis of embryos or sperm donation, which may improve the outcomes of IVF programs.

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About the authors

V. F DOLGUSHINA

Academician V.I. Kulakov Research Center of Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia

Email: n_dolgushina@oparina4.ru
Moscow

S. A SOKUR

Academician V.I. Kulakov Research Center of Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia

Email: sokursv@yandex.ru
Moscow

ZH. I GLINKINA

OOO "Petrovskie Vorota" Maternity and Reproductive Medicine Center

Email: janna435@yandex.ru
Moscow

E. A KALININA

Academician V.I. Kulakov Research Center of Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia

Email: e_kalinina@oparina4.ru
Moscow

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