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Mir-Mehrdad Farsi,
Volume 1, Issue 1 (1-2003)

Background: While traditional semen parameters are of significant clinical value, total fertilization failure in IVF cycles is not uncommon. Sperm function testing such as; Hamster egg penetration test has severed limitations as a clinical test. The aim of this study was to evaluate the predictive value of semen parameters by using of intracellular calcium [Ca2+]I increase in response to progesterone. Materials and Methods: The [Ca2+]i response to progesterone was measured in spermatozoa of 86 patients referring to the Assisted Conception Unit for semen analysis. The patients were divided into 3 groups; according to their semen parameters and measured intracellular [Ca2+]i increasing in response to progesterone . Results: There was no significant correlation between each individual semen parameter and [Ca2+]i elevation in response to the progesterone, but most of the patients in each group had [Ca2+]i increasing as expected based on sperm parameters. However, there were cases in groups 1 and 2 (Normal and IVF) that demonstrated [Ca2+]i increases which were poor or lower than expected. Out of the 22 patients in the normal category, 8 cases had poor response to [Ca2+]I increase and out of the 47 patients in the IVF group, 9 patients were as well. In addition we measured [Ca2+]I increases in 6 fertile donor samples for comparison purposes. Conclusion: [Ca2+]i increase in response to progesterone is related to predicting value of sperm parameters in most cases. However, the response of sperm to progesterone could be different in some cases that are expected in normal or IVF category based on our semen analysis criteria. We suggest that the [Ca2+]i measurements may perfect the sperm fertility potential.
Mir Mehrdad Farsi, Ali Jorsaraei, Mahmood Hajiahmadi, Sedigheh Esmaelzadeh,
Volume 5, Issue 2 (7-2007)

Background: Multiple factors have been suggested for prediction of pregnancy in Intracytoplasmic sperm injection (ICSI) cycles such as the number of injected oocytes, fertilization rate, embryo morphology and quality of transferred embryos. Predictive value of these factors is important in ICSI outcome.
Objectives: To evaluate the role of embryo morphology for prediction of pregnancy in ICSI cycles.
Materials and Methods: This retrospective study was done on 97 patients who were treated by ICSI in Fatemeh Zahra Fertility and Infertility Centre from April 2004 to March 2005.  Number of retrieved oocytes, number of injected oocytes, fertilization rate, zygote morphology, rate of cytoplasmic fragmentation, number of four cell transferred embryos, and quality of embryo transfer, as predictors of pregnancy in ICSI cycles were evaluated. The results analysed by T-test, Mann-Whitney U test and Fisher's exact test. Logistic regression was used to estimate the significance of variables in the prediction of pregnancy probability.
Results: Out of 97 patients, 42 cases of pregnancy were detected (Pregnancy rate: 43.3%). The number of four cell transferred embryos was 112 (53.84%) in pregnant group. Pregnancy occurred in 33 (58.9%) patients with at least one good quality zygote.  The mean number of four cell transferred embryos and the quality of zygotes had significant difference between pregnant and not pregnant groups (p=0.006 and p=0.000 respectively). In logistic regression analysis, the number of four-cell transferred embryos (p=0.007) and the quality of zygotes (p=0.003) were significant predictors of the pregnancy outcome.
Conclusions: Our results suggest that the number of four-cell transferred embryos with ≤ 15% cytoplasmic fragmentation and zygotes with centralized, apposed and polarized pronuclei in women <38 years old are significant predictors for pregnancy in ICSI cycles.

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