Objective: To determine the optimum time interval between semen processing and incubation before intracytoplasmic sperm injection (ICSI) and correlate it with the acrosomal reaction rate.

Design: Controlled randomized study.

Setting: The Egyptian IVF-ET Center.

Patient(s): Couples with male factor infertility undergoing ICSI using ejaculated semen.

Intervention(s): The patients were prospectively randomized according to differences in sperm preincubation time before ICSI into 1-hour, 3-hour, and 5-hour groups. The status of the acrosome was studied using electron microscopy.

Main Outcome Measure(s): The primary outcome measures were fertilization rate and acrosome reaction rate. Secondary outcome measures were the implantation and pregnancy rates.

Result(s): The rate of acrosomally reacted spermatozoa was the highest (68.2%) after 5 hours of incubation and lowest (25.6%) after 1 hour of incubation. The difference was statistically significant. The fertilization rate was the highest (74%) using spermatozoa incubated for 3 hours as compared with 1 hour (70%) and 5 hours (67%), but the difference was not statistically significant.

Conclusion(s): Acrosome reaction is time dependent; the optimum incubation time of spermatozoa before ICSI was 3 hours, which resulted in the highest fertilization rate.

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http://dx.doi.org/10.1016/j.fertnstert.2006.11.176DOI Listing

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