Hassan Sallam1,2 Nooman Sallam2, Ashraf Farrag2, Dalal El-Kaffash1,2 Fathy Ezzeldin2 and Mohamed Abdel-Baqi3
Alexandria University Faculty of Medicine1, Alexandria Fertility and Assisted Reproduction Center2 and Alexandria Regional Center for Women’s Health and Development3, Alexandria, Egypt
Objective: Oxidative stress (OS) is thought to affect the fertilizing capacity of the sperm. This is based on indirect evidence such as the association of OS with sperm parameters in men with normo and oligo-asthenospermia (Agarwal et al, 2018) as well as the relationship between OS and the clinical outcome of ICSI ( Simon et al, 2017). However, the fertilizing capacity of the sperm should ideally be tested in the IVF model. The aim of this work was to evaluate the relationship between oxidative stress in the sperm and its capacity of fertilizing the oocytes in the IVF model.
Design: Prospective study in couples with unexplained infertility treated with combined IVF and ICSI.
Methods: Twenty five couples with unexplained infertility and from whom at least 12 mature oocytes were retrieved were studied during their first cycle of combined IVF/ICSI treatment. Of the retrieved oocytes, 3 to 5 were fertilized by conventional IVF procedure and the rest of the oocytes were treated with ICSI for fear of total fertilization failure. If good embryos resulted from IVF, two were transferred and the rest were frozen. If no fertilization occurred from IVF, 2 embryos resulting from ICSI were transferred and the rest of embryos were frozen. Oxidative stress was measured in the native and processed semen samples by measuring the oxidative reduction potential (ORP) using the MiOXYS platform and the results correlated with the fertilization rate.
Results: A total of 575 oocytes were retrieved from the 25 patients (mean ± SD = 20.5 ± 5.6 oocyte/cycle). Of these 108 oocytes were treated with conventional IVF, a mean (± SD) of 4.2 (± 1.4) oocytes per cycle, resulting in 36 embryos from 14 patients (fertilization rate = 33.3%) of whom 3 became pregnant (pregnancy rate = 21.4%). In 11 patients no oocytes were successfully fertilized by IVF (total fertilization failure) and had embryos resulting from ICSI transferred, resulting in 7 pregnancies (pregnancy rate = 63.6%). In the IVF group, the mean (± SD) ORP in the native semen in couples with =>50% IVF fertilization was significantly lower than in couples with <50% fertilization (2.05 ± 0.7 versus 1.02 ± 0.1; P<0.02). The mean (±SD) ORP in the native semen in patients pregnant with IVF-fertilized oocytes was also significantly lower than in patients pregnant with ICSI-fertilized oocytes (0.99 ± 0.1 versus 2.68 ± 0.7; P <0.05).
Conclusions: It is concluded that the ORP in the native semen is significantly related to the fertilizing capacity of the spermatozoa.