Abstract
In 1992, the first child born from Intra-Cytoplasmic Sperm Injection – ICSI is a milestone for male infertility in assisted reproduction technology – ART. The proportion of ICSI in ART is increasing significantly in recent years, from 72% in 2007 to 81% in 2016. In other ways, ICSI is an important technique that affects the success rate in each IVF center. Therefore, the experience of the embryologist performing ICSI could alter results of the IVF cycle, including fertilization rate, implantation rate and number of usable embryos in that cycle. As a consequence, IVF centers use those factors to create Key performance indicators – KPIs for embryologists commonly a combination of embryology results (degeneration rate, fertilization rate, usable embryo rate) and clinical outcomes (implantation rate, clinical pregnancy rate and live birth rate).
Keywords
References
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[8] R. Maggiulli et al., “The effect of ICSI-related procedural timings and operators on the outcome,” Hum Reprod, vol. 35, no. 1, pp. 32–43, Jan. 2020, doi: 10.1093/humrep/dez234.
[9] L. A. J. Van der Westerlaken, F. M. Helmerhorst, J. Hermans, and N. Naaktgeboren, “Intracytoplasmic sperm injection: position of the polar body affects pregnancy rate,” Human Reproduction, vol. 14, no. 10, pp. 2565–2569, Oct. 1999, doi: 10.1093/humrep/14.10.2565.
[10] J. C. M. Dumoulin et al., “Embryo development and chromosomal anomalies after ICSI: effect of the injection procedure*,” Human Reproduction, vol. 16, no. 2, pp. 306–312, Feb. 2001, doi: 10.1093/humrep/16.2.306.
[11] Blake, M., Garrisi, G. I., & Sadowy, S., “Sperm head and spindle position during intracytoplasmic sperm injection determine fertilization and development outcome.,” In 52nd Annual Meeting of the American Society for Reproductive Medicine., vol. 1;41(1):19–27., no. 4, p. 2, 1996.
[12] P. Rubino, P. Viganò, A. Luddi, and P. Piomboni, “The ICSI procedure from past to future: a systematic review of the more controversial aspects,” Hum Reprod Update, vol. 22, no. 2, pp. 194–227, Apr. 2016, doi: 10.1093/humupd/dmv050.
[13] B. J. Woodward, S. J. Montgomery, G. M. Hartshorne, K. H. Campbell, and R. Kennedy, “Spindle position assessment prior to ICSI does not benefit fertilization or early embryo quality,” Reproductive BioMedicine Online, vol. 16, no. 2, pp. 232–238, Jan. 2008, doi: 10.1016/S1472-6483(10)60579-2.
[14] G. Anifandis, K. Dafopoulos, C. I. Messini, N. Chalvatzas, and I. E. Messinis, “Effect of the position of the polar body during ICSI on fertilization rate and embryo development,” Reprod Sci, vol. 17, no. 9, pp. 849–853, Sep. 2010, doi: 10.1177/1933719110372421.
[15] T. T. Nguyen, H. T. Doan, and L. H. Quan, “The spindle of oocytes observed by polarized light microscope can predict embryo quality,” International Journal of Reproduction, Contraception, Obstetrics and Gynecology, vol. 8, no. 1, pp. 131–134, Dec. 2018, doi: 10.18203/2320-1770.ijrcog20185408.
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[18] Y. Xie, D. Sun, C. Liu, H. Y. Tse, and S. H. Cheng, “A Force Control Approach to a Robot-assisted Cell Microinjection System,” The International Journal of Robotics Research, vol. 29, no. 9, pp. 1222–1232, Aug. 2010, doi: 10.1177/0278364909354325.
[19] F. Karimirad, B. Shirinzadeh, Y. Zhong, J. Smith, and M. Mozafari, “Modelling a precision loadcell using neural networks for vision-based force measurement,” Jul. 09, 2013.
[20] Z. Sun, L. Hao, W. Chen, and Z. Li, “Robotic cell injection force control based on static PVDF sensor and Fuzzy-PID control method,” International Journal of Applied Electromagnetics and Mechanics, vol. 41, no. 1, pp. 73–86, Jan. 2013, doi: 10.3233/JAE-121624.
[21] G. Wang and Q. Xu, “Design and Precision Position/Force Control of a Piezo-Driven Microinjection System,” IEEE/ASME Transactions on Mechatronics, vol. 22, no. 4, pp. 1744–1754, Aug. 2017, doi: 10.1109/TMECH.2017.2698139.
[22] K. Aydos and O. S. Aydos, “Sperm Selection Procedures for Optimizing the Outcome of ICSI in Patients with NOA,” Journal of Clinical Medicine, vol. 10, no. 12, Art. no. 12, Jan. 2021, doi: 10.3390/jcm10122687.
[23] V. Nordhoff, “How to select immotile but viable spermatozoa on the day of intracytoplasmic sperm injection? An embryologist’s view,” Andrology, vol. 3, no. 2, pp. 156–162, 2015, doi: 10.1111/andr.286.
[24] R. S. Jeyendran, H. H. Van der Ven, M. Perez-Pelaez, B. G. Crabo, and L. J. Zaneveld, “Development of an assay to assess the functional integrity of the human sperm membrane and its relationship to other semen characteristics,” J Reprod Fertil, vol. 70, no. 1, pp. 219–228, Jan. 1984, doi: 10.1530/jrf.0.0700219.
[25] H. N. Sallam, A. Farrag, A.-F. Agameya, Y. El-Garem, and F. Ezzeldin, “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,” Hum Reprod, vol. 20, no. 12, pp. 3435–3440, Dec. 2005, doi: 10.1093/humrep/dei249.
[26] N. Charehjooy et al., “Selection of Sperm Based on Hypo-Osmotic Swelling May Improve ICSI Outcome: A Preliminary Prospective Clinical Trial,” Int J Fertil Steril, vol. 8, no. 1, pp. 21–28, 2014.
[27] D. Baldini et al., “Sperm Selection for ICSI: Do We Have a Winner?,” Cells, vol. 10, no. 12, p. 3566, Dec. 2021, doi: 10.3390/cells10123566.
[28] E. De Turner, N. J. Aparicio, D. Turner, and L. Schwarzstein, “Effect of two phosphodiesterase inhibitors, cyclic adenosine 3’:5’-monophosphate, and a beta-blocking agent on human sperm motility,” Fertil Steril, vol. 29, no. 3, pp. 328–331, Mar. 1978, doi: 10.1016/s0015-0282(16)43161-4.
[29] I. Taşdemir, M. Taşdemir, and S. Tavukçuoğlu, “Effect of pentoxifylline on immotile testicular spermatozoa,” J Assist Reprod Genet, vol. 15, no. 2, pp. 90–92, Feb. 1998, doi: 10.1007/BF02766832.
[30] V. Nordhoff, “How to select immotile but viable spermatozoa on the day of intracytoplasmic sperm injection? An embryologist’s view,” Andrology, vol. 3, no. 2, pp. 156–162, Mar. 2015, doi: 10.1111/andr.286.
[31] B. Kovacic, V. Vlaisavljevic, and M. Reljic, “Clinical use of pentoxifylline for activation of immotile testicular sperm before ICSI in patients with azoospermia,” J Androl, vol. 27, no. 1, pp. 45–52, Feb. 2006, doi: 10.2164/jandrol.05079.
[32] H. Hattori, Y. Nakajo, C. Ito, Y. Toyama, K. Toshimori, and K. Kyono, “Birth of a healthy infant after intracytoplasmic sperm injection using pentoxifylline-activated sperm from a patient with Kartagener’s syndrome,” Fertil Steril, vol. 95, no. 7, p. 2431.e9–11, Jun. 2011, doi: 10.1016/j.fertnstert.2011.03.074.
[33] M. Mahaldashtian, M. A. Khalili, S. A. Nottola, B. Woodward, G. Macchiarelli, and S. Miglietta, “Does in vitro application of pentoxifylline have beneficial effects in assisted male reproduction?,” Andrologia, vol. 53, no. 1, p. e13722, Feb. 2021, doi: 10.1111/and.13722.
[34] V. Nordhoff et al., “Optimizing TESE-ICSI by laser-assisted selection of immotile spermatozoa and polarization microscopy for selection of oocytes,” Andrology, vol. 1, no. 1, pp. 67–74, Jan. 2013, doi: 10.1111/j.2047-2927.2012.00020.x.
[35] J. G. Franco Jr et al., “Key performance indicators score (KPIs-score) based on clinical and laboratorial parameters can establish benchmarks for internal quality control in an ART program,” JBRA Assist Reprod, vol. 21, no. 2, pp. 61–66, 2017, doi: 10.5935/1518-0557.20170016.
[2] A. W. Tiegs and R. T. Scott, “Evaluation of fertilization, usable blastocyst development and sustained implantation rates according to intracytoplasmic sperm injection operator experience,” Reproductive BioMedicine Online, vol. 41, no. 1, pp. 19–27, Jul. 2020, doi: 10.1016/j.rbmo.2020.03.008.
[3] A. W. Tiegs and R. T. Scott, “Evaluation of fertilization, usable blastocyst development and sustained implantation rates according to intracytoplasmic sperm injection operator experience,” Reprod Biomed Online, vol. 41, no. 1, pp. 19–27, Jul. 2020, doi: 10.1016/j.rbmo.2020.03.008.
[4] Alpha Scientists In Reproductive Medicine, “The Alpha consensus meeting on cryopreservation key performance indicators and benchmarks: proceedings of an expert meeting,” Reprod Biomed Online, vol. 25, no. 2, pp. 146–167, Aug. 2012, doi: 10.1016/j.rbmo.2012.05.006.
[5] J. G. Franco Jr et al., “Key performance indicators score (KPIs-score) based on clinical and laboratorial parameters can establish benchmarks for internal quality control in an ART program,” JBRA Assist Reprod, vol. 21, no. 2, pp. 61–66, 2017, doi: 10.5935/1518-0557.20170016.
[6] C. G. Petersen et al., “Key performance indicators (KPIs) score to evaluate embryologist performance in art laboratory,” Fertility and Sterility, vol. 110, pp. e239–e240, Tháng Chín 2018, doi: 10.1016/j.fertnstert.2018.07.687.
[7] G. Palermo, H. Joris, P. Devroey, and A. C. Van Steirteghem, “Pregnancies after intracytoplasmic injection of single spermatozoon into an oocyte,” Lancet, vol. 340, no. 8810, pp. 17–18, Jul. 1992, doi: 10.1016/0140-6736(92)92425-f.
[8] R. Maggiulli et al., “The effect of ICSI-related procedural timings and operators on the outcome,” Hum Reprod, vol. 35, no. 1, pp. 32–43, Jan. 2020, doi: 10.1093/humrep/dez234.
[9] L. A. J. Van der Westerlaken, F. M. Helmerhorst, J. Hermans, and N. Naaktgeboren, “Intracytoplasmic sperm injection: position of the polar body affects pregnancy rate,” Human Reproduction, vol. 14, no. 10, pp. 2565–2569, Oct. 1999, doi: 10.1093/humrep/14.10.2565.
[10] J. C. M. Dumoulin et al., “Embryo development and chromosomal anomalies after ICSI: effect of the injection procedure*,” Human Reproduction, vol. 16, no. 2, pp. 306–312, Feb. 2001, doi: 10.1093/humrep/16.2.306.
[11] Blake, M., Garrisi, G. I., & Sadowy, S., “Sperm head and spindle position during intracytoplasmic sperm injection determine fertilization and development outcome.,” In 52nd Annual Meeting of the American Society for Reproductive Medicine., vol. 1;41(1):19–27., no. 4, p. 2, 1996.
[12] P. Rubino, P. Viganò, A. Luddi, and P. Piomboni, “The ICSI procedure from past to future: a systematic review of the more controversial aspects,” Hum Reprod Update, vol. 22, no. 2, pp. 194–227, Apr. 2016, doi: 10.1093/humupd/dmv050.
[13] B. J. Woodward, S. J. Montgomery, G. M. Hartshorne, K. H. Campbell, and R. Kennedy, “Spindle position assessment prior to ICSI does not benefit fertilization or early embryo quality,” Reproductive BioMedicine Online, vol. 16, no. 2, pp. 232–238, Jan. 2008, doi: 10.1016/S1472-6483(10)60579-2.
[14] G. Anifandis, K. Dafopoulos, C. I. Messini, N. Chalvatzas, and I. E. Messinis, “Effect of the position of the polar body during ICSI on fertilization rate and embryo development,” Reprod Sci, vol. 17, no. 9, pp. 849–853, Sep. 2010, doi: 10.1177/1933719110372421.
[15] T. T. Nguyen, H. T. Doan, and L. H. Quan, “The spindle of oocytes observed by polarized light microscope can predict embryo quality,” International Journal of Reproduction, Contraception, Obstetrics and Gynecology, vol. 8, no. 1, pp. 131–134, Dec. 2018, doi: 10.18203/2320-1770.ijrcog20185408.
[16] Y. Ma et al., “Recent advances in critical nodes of embryo engineering technology,” Theranostics, vol. 11, no. 15, pp. 7391–7424, 2021, doi: 10.7150/thno.58799.
[17] Y. Wei and Q. Xu, “Design of a PVDF-MFC Force Sensor for Robot-Assisted Single Cell Microinjection,” IEEE Sensors Journal, vol. 17, no. 13, pp. 3975–3982, Jul. 2017, doi: 10.1109/JSEN.2017.2701835.
[18] Y. Xie, D. Sun, C. Liu, H. Y. Tse, and S. H. Cheng, “A Force Control Approach to a Robot-assisted Cell Microinjection System,” The International Journal of Robotics Research, vol. 29, no. 9, pp. 1222–1232, Aug. 2010, doi: 10.1177/0278364909354325.
[19] F. Karimirad, B. Shirinzadeh, Y. Zhong, J. Smith, and M. Mozafari, “Modelling a precision loadcell using neural networks for vision-based force measurement,” Jul. 09, 2013.
[20] Z. Sun, L. Hao, W. Chen, and Z. Li, “Robotic cell injection force control based on static PVDF sensor and Fuzzy-PID control method,” International Journal of Applied Electromagnetics and Mechanics, vol. 41, no. 1, pp. 73–86, Jan. 2013, doi: 10.3233/JAE-121624.
[21] G. Wang and Q. Xu, “Design and Precision Position/Force Control of a Piezo-Driven Microinjection System,” IEEE/ASME Transactions on Mechatronics, vol. 22, no. 4, pp. 1744–1754, Aug. 2017, doi: 10.1109/TMECH.2017.2698139.
[22] K. Aydos and O. S. Aydos, “Sperm Selection Procedures for Optimizing the Outcome of ICSI in Patients with NOA,” Journal of Clinical Medicine, vol. 10, no. 12, Art. no. 12, Jan. 2021, doi: 10.3390/jcm10122687.
[23] V. Nordhoff, “How to select immotile but viable spermatozoa on the day of intracytoplasmic sperm injection? An embryologist’s view,” Andrology, vol. 3, no. 2, pp. 156–162, 2015, doi: 10.1111/andr.286.
[24] R. S. Jeyendran, H. H. Van der Ven, M. Perez-Pelaez, B. G. Crabo, and L. J. Zaneveld, “Development of an assay to assess the functional integrity of the human sperm membrane and its relationship to other semen characteristics,” J Reprod Fertil, vol. 70, no. 1, pp. 219–228, Jan. 1984, doi: 10.1530/jrf.0.0700219.
[25] H. N. Sallam, A. Farrag, A.-F. Agameya, Y. El-Garem, and F. Ezzeldin, “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,” Hum Reprod, vol. 20, no. 12, pp. 3435–3440, Dec. 2005, doi: 10.1093/humrep/dei249.
[26] N. Charehjooy et al., “Selection of Sperm Based on Hypo-Osmotic Swelling May Improve ICSI Outcome: A Preliminary Prospective Clinical Trial,” Int J Fertil Steril, vol. 8, no. 1, pp. 21–28, 2014.
[27] D. Baldini et al., “Sperm Selection for ICSI: Do We Have a Winner?,” Cells, vol. 10, no. 12, p. 3566, Dec. 2021, doi: 10.3390/cells10123566.
[28] E. De Turner, N. J. Aparicio, D. Turner, and L. Schwarzstein, “Effect of two phosphodiesterase inhibitors, cyclic adenosine 3’:5’-monophosphate, and a beta-blocking agent on human sperm motility,” Fertil Steril, vol. 29, no. 3, pp. 328–331, Mar. 1978, doi: 10.1016/s0015-0282(16)43161-4.
[29] I. Taşdemir, M. Taşdemir, and S. Tavukçuoğlu, “Effect of pentoxifylline on immotile testicular spermatozoa,” J Assist Reprod Genet, vol. 15, no. 2, pp. 90–92, Feb. 1998, doi: 10.1007/BF02766832.
[30] V. Nordhoff, “How to select immotile but viable spermatozoa on the day of intracytoplasmic sperm injection? An embryologist’s view,” Andrology, vol. 3, no. 2, pp. 156–162, Mar. 2015, doi: 10.1111/andr.286.
[31] B. Kovacic, V. Vlaisavljevic, and M. Reljic, “Clinical use of pentoxifylline for activation of immotile testicular sperm before ICSI in patients with azoospermia,” J Androl, vol. 27, no. 1, pp. 45–52, Feb. 2006, doi: 10.2164/jandrol.05079.
[32] H. Hattori, Y. Nakajo, C. Ito, Y. Toyama, K. Toshimori, and K. Kyono, “Birth of a healthy infant after intracytoplasmic sperm injection using pentoxifylline-activated sperm from a patient with Kartagener’s syndrome,” Fertil Steril, vol. 95, no. 7, p. 2431.e9–11, Jun. 2011, doi: 10.1016/j.fertnstert.2011.03.074.
[33] M. Mahaldashtian, M. A. Khalili, S. A. Nottola, B. Woodward, G. Macchiarelli, and S. Miglietta, “Does in vitro application of pentoxifylline have beneficial effects in assisted male reproduction?,” Andrologia, vol. 53, no. 1, p. e13722, Feb. 2021, doi: 10.1111/and.13722.
[34] V. Nordhoff et al., “Optimizing TESE-ICSI by laser-assisted selection of immotile spermatozoa and polarization microscopy for selection of oocytes,” Andrology, vol. 1, no. 1, pp. 67–74, Jan. 2013, doi: 10.1111/j.2047-2927.2012.00020.x.
[35] J. G. Franco Jr et al., “Key performance indicators score (KPIs-score) based on clinical and laboratorial parameters can establish benchmarks for internal quality control in an ART program,” JBRA Assist Reprod, vol. 21, no. 2, pp. 61–66, 2017, doi: 10.5935/1518-0557.20170016.
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