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H Joris

Publications and source records attributed to H Joris.

At least 19 recordsLinked to original sources
PubMed1996

Preimplantation diagnosis for X and Y normality in embryos from three Klinefelter patients.

In some 47,XXY Klinefelter patients without evidence of mosaicism, testicular spermatozoa can be successfully recovered and used for intracytoplasmic sperm injection (ICSI). To ensure the replacement of embryos with a normal X and Y chromosome pattern, preimplantation diagnosis can be performed. This paper reports on three 47,XXY Klinefelter patients from whom it was possible to retrieve testicular spermatozoa in order to perform ICSI. From their healthy wives a total of 27 oocyte-cumulus complexes were retrieved from which 22 metaphase-II oocytes were obtained and injected; 19 of these were intact after injection. Two distinct pronuclei were observed in eight oocytes (42.1%) 18 h after injection. On day 3 of development, five embryos (62.5%) had reached at least the 6-cell stage and were of sufficient quality to undergo biopsy and subsequent preimplantation diagnosis for sex chromosome analysis by fluorescent in-situ hybridization. The four embryos diagnosed as normal were transferred to three respective patients, resulting in one biochemical pregnancy. The remaining cells of the fifth embryo were analysed afterwards, revealing a normal X and Y chromosome constitution. So far, in the five embryos diagnosed, a normal sex chromosome pattern has been observed.

Embryo, Mammalian↗
PubMed1995

Intracytoplasmic sperm injection (ICSI): the Brussels experience.

The present report covers the results of a 26-month period in which 1275 consecutive treatment cycles by intracytoplasmic sperm injection (ICSI) were performed in 919 couples. These couples were afflicted with male factor infertility and had had at least one previous failed conventional in vitro fertilization (IVF) treatment cycle. In other couples, the husband had semen parameters incompatible with conventional IVF or suffered from excretory azoospermia which required microsurgical epididymal sperm aspiration or testicular sperm retrieval. Overall, the 2 pronuclear (PN) fertilization rate was 47.7% per retrieved oocyte-cumulus complex and 66.4% per successfully injected metaphase II oocyte. Embryo transfer was performed in 90.8% of started cycles and 362 clinical pregnancies were recorded, giving a clinical pregnancy rate of 28.4% per started cycle or 31.3% per transfer. In addition, updated results on the outcome of pregnancies after microassisted fertilization are presented. As of 30 August 1994, 416 children have been born. Although 16 major congenital malformations have been observed (3.9%), there appears to be no reason for serious concern as regards the occurrence of major congenital anomalies after ICSI.

Belgium↗
PubMed1995

Intracytoplasmic sperm injection in the mouse.

Intracytoplasmic sperm injection (ICSI) into mouse oocytes involves a very low survival rate. This study was designed to determine why ICSI frequently fails in mice. Metaphase II oocytes were obtained from superovulated 4-6 week old F1 hybrid mice. Spermatozoa were retrieved from the epididymis of 12-14 week old F1 hybrid mice. The spiked microinjection pipette used to inject a spermatozoon into the ooplasm had outer and inner diameters of 10 and 8 microns respectively. The oocytes used in the first part of the study were not activated (group 1). Some oocytes were incubated with calcium ionophore for 5 min (group 2). The injected oocytes were evaluated 6, 20, 48 and 72 h after injection. A total of 143 eggs in each group underwent ICSI. In group 1, sperm heads escaped into the perivitelline space. In all, 63 (47%) of the remaining oocytes were damaged during the injection or had degenerated by the first evaluation. The survival rate was 53%, but fertilization did not occur. In group 2, 31 oocytes (22%) were damaged during microinjection or soon degenerated. Two oocytes underwent accidental subzonal insemination. Six oocytes were fertilized (4.2%) among the 78% of survivors. After injection, the sperm tail was found in the cytoplasm (27 and 31% in groups 1 and 2 respectively), the perivitelline space (45% in both groups) or protruding through the zona pellucida (28 and 23% respectively). More oocytes degenerated when the tail remained in the cytoplasm, i.e. 78% in group 1 and 36% in group 2.

Animals↗
PubMed1995

Oocyte and embryo quality as well as pregnancy rate in intracytoplasmic sperm injection are not affected by high follicular phase serum progesterone.

The effect of elevated serum progesterone concentrations (> 1 ng/l) on or before the day of human chorionic gonadotrophin (HCG) injection on the outcome of women receiving gonadotrophin-releasing hormone analogue (GnRHa)/human menopausal gonadotrophin (HMG) for ovarian stimulation prior to intracytoplasmic sperm injection (ICSI) was evaluated. A total of 1275 ICSI cycles were analysed retrospectively. In 53 cycles (4.5%), serum progesterone concentrations were > 1 ng/ml. Patients in the high progesterone group had significantly higher oestradiol and luteinizing hormone concentrations on the day of HCG injection. The characteristics of the cumulus-corona cell complexes and the nuclear maturity of the oocytes were similar in the groups of patients with high and low serum progesterone levels. Fertilization and cleavage rates as well as embryo quality were not different in the two groups. No difference in implantation or clinical pregnancy rates was observed between the high progesterone and low progesterone groups. Moreover, the cumulative exposure to progesterone during the follicular phase, as expressed by the area under the curve (AUC), and the duration of exposure to high serum progesterone levels (> 1 ng/ml) were not significantly different between pregnant and non-pregnant women in the high progesterone group. We conclude that in ICSI cycles pretreated with GnRHa, increased serum progesterone concentrations on or before the day of HCG injection do not affect ICSI outcome.

Adult↗
PubMed1995

The influence of the site of sperm deposition and mode of oolemma breakage at intracytoplasmic sperm injection on fertilization and embryo development rates.

The aims of this study were to examine, in a prospective, controlled way, the effect of the sperm deposition site in the oocyte and the mode of oolemma breakage in intracytoplasmic sperm injection (ICSI) on fertilization and embryo development rates. In the first trial (100 cycles in total), the spermatozoa were deposited further from the meiotic spindle (polar body at the 12 o'clock position) in half of the oocytes (n = 649), while in the other half (n = 605) the spermatozoa were deposited nearer to the meiotic spindle (polar body at the 6 o'clock position). In the second trial (6860 oocytes in 624 cycles), five different modes of membrane breakage (the reaction of the oolemma to the penetrating injection needle) at the moment of injection were noted: oolemma breakage, type A pricking once, no suction (n = 1401); type B, pricking once, small suction (n = 2761); type C, pricking once, long suction (n = 2310); type D, pricking twice or more, no or small amount of suction (n = 259); and type E, pricking twice or more, long suction (n = 129). No differences were observed between the 12 and 6 o'clock positions in the survival rate (90 and 90% respectively) and in the normal fertilization rates (78 and 77% respectively). Significantly more transfer quality embryos (< or = 50% fragmentation) were obtained in the 6 o'clock position group (83%) than in the 12 o'clock position group (79%). In the second trial, significantly lower survival rates were noted after membrane breakage type A (82%) than after breakages of types B, C, D and E (93, 92, 88 and 88% respectively). There were no significant differences present in the normal fertilization rates (70, 72, 70, 71 and 73% for types A-E respectively), but significantly more freeze quality embryos (< or = 20% fragmentation) were obtained after injection B (65%) than after injection types A, C, D and E (59, 61, 55 and 51% respectively). In conclusion, the site of sperm deposition in the oocyte does not influence the normal fertilization rate but does affect the embryo development rate. Furthermore, the mode of membrane breakage does not influence the normal fertilization rate but does affect oocyte survival and embryo development rates.

Adult↗
PubMed1995

Successful fertilization and establishment of pregnancies after intracytoplasmic sperm injection in patients with globozoospermia.

Globozoospermia or round-headed spermatozoa is a rare type of teratozoospermia where the acrosome is absent resulting in male infertility with no known therapy. A few studies have shown that round-headed spermatozoa cannot bind to or penetrate the zona pellucida, and no normal fertilization has been observed in in-vitro fertilization (IVF) after insemination of human oocytes with round-headed spermatozoa. In this study, the fertilization capacity of round-headed spermatozoa after intracytoplasmic sperm injection (ICSI) into human oocytes has been examined. In pre-clinical experiments, 45 oocytes were injected; 41 oocytes were intact after injection, 15 oocytes were fertilized normally, and 13 of these 15 oocytes developed further in vitro. ICSI was carried out in 11 treatment cycles of seven infertile couples with globozoospermia. Normal fertilization and embryo transfer occurred in four cycles (three patients). Positive serum human chorionic gonadotrophin was observed in three cycles (two patients); one patient had a pre-clinical abortion and the other patient became pregnant twice; the first pregnancy was ectopic and the second pregnancy is a twin pregnancy which is currently at 16 weeks of gestation.

Acrosome↗
PubMed1995

Ongoing pregnancies and birth after intracytoplasmic sperm injection with frozen-thawed epididymal spermatozoa.

In seven patients who did not become pregnant following microsurgical epididymal sperm aspiration (MESA) and intracytoplasmic sperm injection (ICSI), a subsequent ICSI was performed using previously cryopreserved super-numerary epididymal spermatozoa without re-operating on the husband. During the original MESA procedure a mean sperm concentration of 12.3 x 10(6)/ml was achieved. The supernumerary spermatozoa were cryopreserved for later use. After thawing frozen epididymal spermatozoa a mean concentration of 1.9 x 10(6) spermatozoa/ml was obtained in straws containing a total volume of sperm suspension of 250 microliters. From 68 intact oocytes injected with frozen-thawed epididymal spermatozoa, a two pronuclear fertilization rate of 45% and a cleavage rate of 82% were obtained. A total of 17 embryos were replaced in the seven patients, resulting in two ongoing singleton pregnancies and one twin delivery. Six embryos were cryopreserved. In conclusion, it would appear mandatory to cryopreserve supernumerary spermatozoa during a MESA in order to avoid subsequent further scrotal surgery.

Adult↗
PubMed1995

The result of intracytoplasmic sperm injection is not related to any of the three basic sperm parameters.

High success rates have been reported for the use of intracytoplasmic sperm injection (ICSI) in alleviating essentially andrological infertility. However, neither the relationship between any of the sperm parameters and the result of ICSI nor the minimal sperm requirements for ICSI have been investigated so far. In this paper, our objective was therefore to study the relationship between three basic sperm parameters (total sperm count, sperm motility and morphology) and the outcome of ICSI by retrospective analyses of fertilization, embryo development and pregnancy rates in 966 micro-injection cycles, performed with ejaculated semen. The results showed that there was no important influence from either the type or the extent of sperm impairment on the outcome of ICSI. Even in the most extreme cases of male-factor infertility, where cryptozoospermia or total astheno- or total teratozoospermia was diagnosed in the initial semen sample, high fertilization and pregnancy rates were obtained by ICSI. Only one condition had a strongly negative influence on the result of ICSI: where an immotile (presumably dead) spermatozoon was injected into the oocyte. Thus the only ultimate criterion for successful ICSI is the presence of at least one living spermatozoon per oocyte in the pellet of the treated semen sample used for micro-injection.

Cytoplasm↗
PubMed1995

Results of 55 intracytoplasmic sperm injection cycles in the treatment of male-immunological infertility.

Antisperm antibodies present in the semen can be a primary cause of infertility. If the proportion of spermatozoa carrying antisperm antibodies is very high, then usually a poor result ensues in standard in-vitro fertilization. We therefore employed intracytoplasmic sperm injection (ICSI) in 55 cycles (37 patients) where the proportion of antisperm antibody-bound spermatozoa was 80% or higher, as determined by the mixed antiglobulin reaction (MAR) test. The type and location of antisperm antibodies were determined by the immunobead test in 30 of the 37 patients. The mean normal fertilization rate was 75.7% in these 55 cycles, which was significantly higher than the fertilization rate in another 1767 ICSI cycles (69.2%) performed over the same period and where MAR-negative semen (the level of antisperm antibodies was < 80%) was used for microinjection. Embryonic development was comparable, but a higher proportion of poor-quality embryos was obtained with MAR-positive than with MAR-negative semen samples. Out of the 55 patients, 53 had embryos replaced (96.4%) and a fetal sac was detected by ultrasonography in 14 patients (26.4%). The data indicate that fertilization, embryo development and pregnancy rates after ICSI are not influenced significantly by the proportion of antisperm antibody-bound spermatozoa, nor by the dominant type of antibodies present, nor by the location of the antisperm antibody on the spermatozoa. The conclusion of this study is that ICSI should be the primary choice for patients who have high numbers of antisperm antibodies present in their semen.

Adult↗
PubMed1995

Prospective, auto-controlled study on reinsemination of failed-fertilized oocytes by intracytoplasmic sperm injection.

OBJECTIVE: To evaluate the possible influence of late fertilization after standard IVF on the results of reinsemination of assumed failed-fertilized oocytes by microinjection and to examine the correlation between the effect of aging of (failed-fertilized) oocytes and the ability of these oocytes to become fertilized. DESIGN: Trial 1: Group 1 (injected-day 1), 93 failed-fertilized oocytes injected 1 day after ovum pick-up; group 2 (control), 82 failed-fertilized oocytes with no microinjection performed. Trial 2: Group 1 (ICSI-day 1), 40 failed-fertilized oocytes injected 1 day after ovum pick-up; group-2 (ICSI-day 2), 40 failed-fertilized oocytes injected 2 days after ovum pick-up. In addition, 35 two- to eight-cell stage embryos, obtained after ICSI of IVF failed-fertilized oocytes, were fixed for cytogenetic analysis. MAIN OUTCOME MEASURES: Normal and abnormal fertilization and embryo development. RESULTS: Trial 1: 53% normal (2 pronuclear [PN]) and 25% abnormal (> or = 3PN) fertilization rates were obtained in group 1 (injected-day 1), and 71% of the 2PN and 74% of the > or = 3PN oocytes cleaved with < 50% fragmentation. No pronuclear (> or = 2PN) development occurred in the control group. Trial 2: 45% and 8% normal and 25% and 40% abnormal fertilization rates were obtained, respectively, after ICSI of 1-day-old and 2-day-old failed-fertilized oocytes. Two days after microinjection, 67% and 67% of the 2PN and 80% and 44% of the > or = 3PN oocytes cleaved with < 50% fragmentation in group ICSI-day 1 and in group ICSI-day 2, respectively. CONCLUSIONS: Late fertilization after initial in vitro insemination does not play a role in the high fertilization rate obtained after reinsemination of assumed failed-fertilized oocytes by ICSI. Normal (2PN) fertilization rate, however, decreases strongly and the abnormal (> or = 3PN) fertilization rate increases with oocyte aging and derived embryos seem to have a high incidence of cytogenetic abnormalities.

Cell Nucleus↗
PubMed1995

Analysis of 76 total fertilization failure cycles out of 2732 intracytoplasmic sperm injection cycles.

From October 1992 to December 1994, 2732 cycles of treatment by intracytoplasmic sperm injection (ICSI) were carried out in couples mainly with severe male-factor infertility. The overall fertilization rate in these 2732 cycles was 71% of intact oocytes. However, in 76 (72 couples) of these cycles, none of the injected oocytes became fertilized, so the total fertilization failure rate was 3% (76/2732 cycles). Details of these 76 cycles were analysed. The results show that total fertilization failure after ICSI may be explained by different factors related to (i) semen characteristics (only immotile or round-headed spermatozoa for ICSI) or (ii) the oocytes (number, abnormal morphology, damage after ICSI). Of 26 couples, 22 achieved fertilization in their subsequent ICSI cycles. In conclusion, total fertilization failure after ICSI for the treatment of severe male-factor infertility was mainly caused by the poor viability of the spermatozoa used for injection; it was also associated with a low number and poor quality of oocytes. Repeated ICSI treatment may be useful or necessary in couples with total fertilization failure.

Adult↗
PubMed1994

Intracytoplasmic sperm injection.

Intracytoplasmic sperm injection (ICSI) is a promising assisted fertilization technique that may benefit women who have not become pregnant by in-vitro fertilization. ICSI and subzonal insemination (SUZI) were used to treat couples who failed fertilization after standard IVF or who could not be accepted for IVF because too few motile spermatozoa were present in the ejaculate. This paper describes the outcome of 750 consecutive cycles of SUZI and ICSI. Different aspects of these novel assisted fertilization procedures are described: patient management, ovarian stimulation, semen evaluation and treatment, oocyte collection and preparation, SUZI and ICSI techniques, assessment of fertilization and embryo cleavage, outcome of embryo transfers and the evolution of the pregnancies.

Embryo Transfer↗
PubMed1994

Assisted fertilization by subzonal insemination and intracytoplasmic sperm injection.

The results of 600 consecutive treatment cycles of subzonal insemination (SUZI) and intracytoplasmic sperm injection (ICSI) are described in couples with failed fertilization after standard IVF or insufficient spermatozoa in the ejaculate for IVF. More oocytes were damaged by ICSI (16.3%) than by SUZI (8.5%) and the normal fertilization rate was substantially higher after ICSI (49.1% v. 16.6%). Subsequent development of two-pronuclear oocytes in vitro was 80% after SUZI and 73.9% after ICSI. Significantly more triple embryo replacements were carried out after ICSI than after SUZI. Embryo transfers were possible in 421 of the 600 cycles. There were 63 pregnancies after ICSI (215 transfers) and 23 after SUZI (156 transfers); 10 additional pregnancies were achieved after 50 transfers of a mixture of SUZI and ICSI embryos. The results of fetal karyotypes and follow-up of the children do not indicate an increase in congenital malformations.

Adult↗
PubMed1994

Intracytoplasmic sperm injection does not require special treatment of the spermatozoa.

In order to assess whether specific treatment of spermatozoa is required prior to intracytoplasmic sperm injection (ICSI), three methods of sperm preparation were compared in this study. These three methods were (A) incubation of spermatozoa with pentoxifylline (PTX) and 2-deoxyadenosine (DOA), (B) electroporation followed by incubation in medium with PTX, and (C) no further treatment with the Percoll gradient. Controlled comparisons were carried out between method A and method B in 21 patients, and between method A and method C in 32 patients. There was no difference in the rates of fertilization and embryo cleavage when ICSI was done with spermatozoa treated by procedures A, B or C. Furthermore, the sperm selection procedure prior to ICSI was done in two different media: T6 medium containing 1.78 mM CaCl2.2H2O and a final washing step after the Percoll gradient in T6 medium containing 5.0 mM CaCl2.2H2O, and Earle's medium containing 1.78 mM CaCl2.2H2O. The results of ICSI on sibling oocytes from 12 patients revealed no difference in the fertilization and embryo cleavage rates between the two different media used during the sperm selection procedures. In conclusion, it appears that high fertilization and pregnancy rates can be obtained in couples with severe male-factor infertility by ICSI and that no special treatment of the spermatozoa prior to ICSI is required.

Colloids↗
PubMed1994

Time-course of oocyte activation, pronucleus formation and cleavage in human oocytes fertilized by intracytoplasmic sperm injection.

Knowledge of the timing of the stages of fertilization in humans is still limited because the time of gamete fusion is not known when pre-ovulatory or in-vitro matured cumulus-enclosed oocytes are inseminated. We therefore studied the morphological nuclear changes in 14 patients' oocytes by means of light microscopic observation at 2, 4, 6, 8, 16, 18 and at 20 h after intracytoplasmic single sperm injection (ICSI). A total of 144 metaphase II oocytes were injected with the spermatozoa of the patients' partners. Out of the 134 oocytes that survived the injection, 93 displayed two pronuclei in the course of the observation period (69%). Out of the 93 normally fertilized oocytes, 21 extruded the second polar body at 2 h after micro-injection (23%) and 63 oocytes at 4 h (68%). Pronuclei appeared as early as 6 h after ICSI in 16 normally fertilized oocytes (17%). At 8 h, 75 (80%) oocytes had two visible pronuclei, at 16 h 92 (99%), at 18 h 76 (82%) and at 20 h 63 (68%). In 24 oocytes (26%) the appearance of pronuclei was asynchronous, while the disappearance of the pronuclei was always synchronous, except in one oocyte. Nine of the 134 successfully injected oocytes showed three equal-sized pronuclei (6.7%). Four of the nine multi-pronucleated oocytes did not extrude the second polar body at all, while the time sequence of appearance of pronuclei was similar to that of the normally fertilized oocytes.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1994

Cryopreservation of supernumerary multicellular human embryos obtained after intracytoplasmic sperm injection.

OBJECTIVE: To investigate the pregnancy rate of frozen-thawed human supernumerary multicellular embryos that were cryopreserved after intracytoplasmic sperm injection or IVF. DESIGN: A clinical study. SETTING: Consenting patients in an academic research environment. PATIENTS: Couples with severe male infertility, indicated by failed or sporadic fertilization after IVF or subzonal insemination or by < 500,000 progressively motile spermatozoa in the entire ejaculate, and couples for IVF during the same period. INTERVENTIONS: After microinjection or IVF, the three best-quality embryos were transferred, and 1,171 embryos from intracytoplasmic sperm injection compared with 2,495 embryos from IVF were frozen with dimethyl sulphoxide. Of these, 413 and 969 embryos were thawed, respectively. MAIN OUTCOME MEASURE: The survival rate, the total and clinical pregnancy rates, the delivery rate, and the preclinical abortion rate were calculated. RESULTS: Fifty-three percent of the thawed intracytoplasmic sperm injection embryos survived. Twenty-two pregnancies have been established in 101 transfers, corresponding to a total pregnancy rate of 21.8% per transfer. The clinical pregnancy rate was 12.9% per transfer and the delivery rate was 5.9% per transfer. Of the IVF embryos, 51% survived and 37 pregnancies have been established in 253 transfers. The total and clinical pregnancy rates and the delivery rate were 14.6%, 10.7%, and 7.1%, respectively. The preclinical abortion rate was 40.9% for cryopreserved intracytoplasmic sperm injection embryos and 27.0% for IVF embryos. CONCLUSIONS: The high incidence of preclinical abortions after transfer of human embryos cryopreserved after intracytoplasmic sperm injection requires extension of the series.

Abortion, Spontaneous↗
PubMed1993

Sperm characteristics and outcome of human assisted fertilization by subzonal insemination and intracytoplasmic sperm injection.

OBJECTIVE: To investigate the influence of sperm characteristics on the treatment by subzonal insemination (SUZI) and intracytoplasmic sperm injection of couples with severe male infertility. DESIGN: A retrospective analysis of 300 consecutive cycles of assisted fertilization concerning 202 infertile couples was performed. One hundred fifty-three couples underwent 362 unsuccessful IVF cycles, whereas on 49 couples IVF was not performed because of poor sperm characteristics. SETTING: Procedures were performed in an institutional research environment. PATIENTS, PARTICIPANTS: Couples in which the male partner was the presumed cause of repeated failure to achieve conception by IVF or in which seminal parameters were unacceptable for IVF. INTERVENTIONS: Three hundred transvaginal oocyte retrievals were performed after superovulation by GnRH agonist and gonadotropins. MAIN OUTCOME MEASURES: After SUZI and intracytoplasmic sperm injection the following parameters were evaluated: fertilization, cleavage, pregnancy, and implantation rates in relation to the sperm parameters and the proportion of acrosome-free spermatozoa after different treatments. RESULTS: Normal fertilization occurred in 18% of the oocytes treated by SUZI and in 44% after intracytoplasmic sperm injection. Only the treatment by electroporation showed a positive correlation with the fertilization rate. Fourteen pregnancies were obtained after SUZI, 8 pregnancies after intracytoplasmic sperm injection, and 8 pregnancies after a combination of the two procedures. A score calculated from the sperm parameters after selection correlated with the fertilization obtained after SUZI, whereas a score calculated from the parameters before sperm selection correlated with the pregnancy rate. Sperm morphology influenced the implantation rate of the embryos obtained with these two procedures. CONCLUSIONS: Intracytoplasmic sperm injection and SUZI can successfully treat couples who fail IVF or who cannot benefit from IVF. Different treatments can be applied to semen samples to increase the number of acrosome-reacted spermatozoa. The few significant relations found between sperm characteristics and the outcome of assisted fertilization cannot predict the outcome.

Adult↗