Publication:

Does the oocyte quality impact intracytoplasmic sperm injection outcomes in severe male factor infertility: a retrospective study

Background ICSI has transformed the approach in treating severe male factor infertility, however the quality of oocyte plays a significant role in compensating for sperm abnormalities and enhancing the clinical outcomes. The study aims to evaluate the impact of oocyte quality on fertilization rates, embryo development and pregnancy outcomes in couples undergoing intracytoplasmic sperm injection (ICSI) in two distinct groups- cryptozoospermia and azoospermia.

Methods A retrospective observational study was conducted at a fertility centre in a tertiary hospital. A total of 61 couples with male infertility were included in the study. Group 1 includes 42 patients diagnosed with cryptozoospermia and Group 2 includes 19 patients diagnosed with azoospermia. Controlled ovarian stimulation was done using gonadotrophins to induce follicular development followed by ICSI procedure. All the retrieved oocytes were categorized based on the morphology criteria outlined in the Istanbul consensus into two distinct groups: oocytes with normal morphology and oocytes with abnormal morphology. Clinical outcomes including fertilization rate, implantation rate, pregnancy rate and miscarriage rate were evaluated.

Results The observed fertilization rate in oocytes with normal morphology and oocytes with abnormal morphology was 84.03% vs. 78.26% in the cryptozoospermia group and 80.76% vs. 78.57% in the azoospermia group. The overall pregnancy rate was 26.19% in group 1 and 31.58% in group 2 with no statistical significance.  Oocytes with normal morphology exhibited higher pregnancy rates, while oocytes with abnormal morphology showed very low or no pregnancy in both groups.

Conclusions The study concludes oocyte quality has a greater impact on the ICSI outcomes irrespective of the type of sperm used. Future studies with a large cohort size are needed to validate these findings.