Biomedical subjects

Yehia El-Garem

Publications and source records attributed to Yehia El-Garem.

3 recordsLinked to original sources

PubMed2005

The use of the modified hypo-osmotic swelling test for the selection of immotile testicular spermatozoa in patients treated with ICSI: a randomized controlled study.

BACKGROUND: Various methods for the selection of viable sperm from among immotile testicular spermatozoa for use in ICSI have been described in non-randomized studies. We have conducted a randomized controlled study to compare the use of the modified hypo-osmotic swelling (HOS) test (50% culture medium + 50% Milli-Q grade water) with that of sperm selection on the basis of their morphology alone. METHODS: A total of 79 couples with immotile testicular spermatozoa treated with ICSI were randomly assigned into two groups. In the first group, spermatozoa used for injection were selected using the modified HOS test, while in the second group spermatozoa were selected on the basis of their morphology. RESULTS: The fertilization rate was significantly higher in the HOS test group (43.6%) compared with the no-HOS test group (28.2%) [odds ratio (OR) 2.494; 95% confidence interval (CI) 1.606-3.872]. The pregnancy and ongoing pregnancy rates were also higher in the HOS test group (27.3% versus 20.5%) compared with the no-HOS test group (5.7% versus 2.9%) (OR 6.188, 95% CI 1.282-29.860; and OR 8.743, 95% CI 1.050-72.783, respectively). CONCLUSIONS: The use of the modified HOS test for the selection of viable sperm from among immotile testicular spermatozoa for ICSI results in higher fertilization, pregnancy and ongoing pregnancy rates compared with morphological selection.

Adult↗

PubMed2003

Relationship between human sperm morphology and acrosomal function.

PURPOSE: In this study, we investigated the relationship between functionality of the acrosome and sperm morphology. METHODS: Acrosome reaction (AR) was separately determined in live and dead sperm and in those with normal, small, and large sized acrosomes by means of the triple stain. Morphology was analyzed according to strict criteria after Papanicolaou stain. RESULTS: AR and morphology correlated regarding detection of large and small sized acrosomes, but not for normal sized acrosomes. Spontaneous AR was significantly influenced by acrosomal size. Sperm with large (11.4%) and normal (9.2%) acrosomes exhibited a significantly higher percentage of life spontaneously acrosome-reacted sperm than those with small acrosomes (4.5%). Sperm with small acrosomes were associated with a higher percentage of cell death. CONCLUSION: The results indicate that sperm with small acrosomes are more susceptible to cell death and nonphysiological acrosomal loss. Acrosome size reflects the physiological capability of sperm function and therefore male fertility potential.

Acrosome↗

PubMedDate not supplied

Defining poor responders in assisted reproduction.

OBJECTIVE: The aim of this study was to establish an objective definition of "poor responders" for patients undergoing treatment with assisted reproduction. METHODS: A total of 782 infertile couples treated with assisted reproduction were studied by retrospective analysis of the data. Simple linear regression was performed between the number of oocytes retrieved and the clinical pregnancy rate. The sensitivity and specificity were then calculated and the receiver-operator characteristic (ROC) curves were drawn in order to determine a critical number of oocytes retrieved below which the clinical pregnancy rate was significantly diminished. RESULTS: An excellent correlation was found between the number of oocytes retrieved and the clinical pregnancy rate (r = 0.90). The clinical pregnancy rate started to become significantly lower when fewer than 5, 6, and 8 oocytes were retrieved from patients treated with ICSI, IVF, or TeSE/ICSI, respectively. CONCLUSIONS: The definition of poor responders in assisted reproduction depends on the treatment modality. Poor responders are patients undergoing treatment with ICSI, IVF, or TeSE/ICSI from whom fewer than 5, 6, or 8 oocytes are retrieved, respectively.

Adult↗