New Approach of Hyaluronic Acid Bound Spermatozoa-ICSI in Iraqi Infertile Patients

Background: Ability of spermatozoa to binding to hyaluronan is related to sperm membrane maturity and fertilizing potential, thus it has been suggested that sperm selection using Hyaluronic acid (HA) could increase the implantation rate in Intracytoplasmic Sperm Injection(ICSI). Basically Physiological -ICSI (PICSI) is a scientific technique used in ICSI, is a specialized form and more filtered way of selecting the best competent sperm for fertilization process. Despite the fact that conventionally spermatozoa are selected for ICSI based on their morphology and motility. Objective: To evaluate whether (PICSI) has the potential to improve the fertilization rate and embryo grading. Patients, Materials and Methods: Fifty-three infertile couples subjected to an in vitro fertilization stimulation program; Thirty-five underwent (ICSI) cycle and eighteen underwent (PICSI) cycle, assessed the fertilization rate and embryo grading at cleavage stage then the results were statistically analyzed. Results: In spite of the fertilization rate of PICSI group was better than ICSI group but statistically no significant difference was noticed between both of them. In regarding to embryo grading at cleavage stage, there was a significant increase(P<0.05) in Grade 1 and Grade 2 for PICSI group as compared to ICSI group. Conclusions: The percentage of fertilization for PICSI group is better than for ICSI group. In regarding to statistical analysis, there was no significant differences between two groups. Regarding to embryo quality at cleavage stage, the PICSI cycle significantly improves embryo quality(Grade 1 and Grade 2) at day 2 and day 3 of development as compared to the ICSI cycle.