Comparison of two ready-to-use systems designed for sperm-hyaluronic acid binding selection before intracytoplasmic sperm injection: PICSI versus Sperm Slow: a prospective, randomized trial

Capsule:
PICSI and Sperm Slow allow comparable clinical efficiency in selecting HA-bound spermatozoa.

Authors:
Lodovico Parmegiani, M.Sc., Graciela Estela Cognigni, M.D., Silvia Bernardi, B.Sc, Enzo Troilo, B.Sc., Stefania Taraborrelli, M.D., Alessandra Arnone, B.Sc., Antonio Manuel Maccarini, B.Sc., Marco Filicori, M.D.

Volume 98, Issue 3, Pages 632-637, September 2012

Abstract:

Objective:
To compare in a strict randomized way the efficiency of two ready-to-use systems for hyaluronic acid (HA)-ICSI: an HA culture dish (PICSI Sperm Selection Device), and a viscous medium containing HA (Sperm Slow).

Design:
Prospective, randomized study

Setting:
GynePro Medical Centers, Bologna, Italy

Patient(s):
50 subjects per treatment group (100 total)

Intervention(s):
100 ICSI treatments randomly carried out with PICSI or with Sperm Slow for sperm selection. Randomization conducted with sealed envelopes. ICSI performed by a single embryologist with 5-year experience in HA-ICSI.

Mean outcome measure(s):
Primary outcome measure: good-quality embryo rate.

Secondary outcome measures:
Oocyte fertilization, pregnancy and implantation rate, and the duration of the ICSI procedure.

Result(s):
Good quality embryo rate comparable between the two groups (58,5% PICSI® versus 56% Sperm Slow™ – P=0.691). Overall, no statistically significant differences in secondary outcome measures except ICSI procedure duration, which was 3 minutes longer (P≤0.001) in the PICSI® group.

Conclusion(s):
Both PICSI® and Sperm Slow™ allow comparable clinical efficiency in selecting HA-bound spermatozoa.

Clinical Trials Registration number:
ISRCTN72668039

  • lodo

    Sorry Kivan and Jim I’ve seen only now your comments

    To kivan: we didn’t find any specific semen parameter that benefit most from HA selection. Yes, we use routinely Sperm Slow for ICSI and IMSI.

    To Jim: no CASA data, I’m sorry.
    I think that there are subgroups of embryologists that benefit more from PICSI rather than SS, and viceversa 😉
    ciao

    lodo

  • This is an excellent study. To follow up on kivan’s comment, do the authors also have CASA data on the sperm used for this analysis, if so, it would be very interesting to see if there are subgroups that benefit more from PICSI vs. Sperm Slow.

  • kivan

    Very nice study! With the authors extensive experience using HA-based sperm selection for ICSI, have you found specific semen parameters that benefit most from physiologic sperm selection? Do you use some form of HA-based selection for all ICSI cases?
    Thanks

  • NicoGarrido

    Congratulations
    to the authors for such an extensive test of both sperm selection methods

    From the
    materials and methods section, in the part corresponding to sample size
    calculation the authors stated that the rates of good embryos were “60%,
    as obtained by the same embryologist designated for the study in the previous 5
    months (approximately 400 embryos obtained over 100 ICSI performed). This
    analysis revealed that at least 196 embryos would be necessary for each group
    to obtain a power of 80% and a confidence interval of 95%.

    For this reason,
    considering a mean number of four embryos obtainable per ICSI cycle, we
    estimated the number of 50 ICSI per each group.”

    But I am missing
    the hypothesized differences in the % between the two methods that they
    considered to calculate the number of samples needed.

    Can the authors
    address this point?

    Thank you!

    Congratulations
    to the authors for such an extensive test of both sperm selection methods

    From the
    materials and methods section, in the part corresponding to sample size
    calculation the authors stated that the rates of good embryos were “60%,
    as obtained by the same embryologist designated for the study in the previous 5
    months (approximately 400 embryos obtained over 100 ICSI performed). This
    analysis revealed that at least 196 embryos would be necessary for each group
    to obtain a power of 80% and a confidence interval of 95%.

    For this reason,
    considering a mean number of four embryos obtainable per ICSI cycle, we
    estimated the number of 50 ICSI per each group.”

    But I am missing
    the hypothesized differences in the % between the two methods that they
    considered to calculate the number of samples needed.

    Can the authors
    address this point?

    Thank you!

    • lodo

      Hi Nico,
      it was 5%. You are right, we should have add this information, thank you
      ciao
      lodo

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