Herts & Essex Fertility’s Senior Clinical Embryologist, Lucy Richardson writes about the seminar entitled ‘New technologies in IVF’ that she co-hosted at this year’s Fertility Show.
New technologies in IVF
A team of clinicians, nurses, embryologists and administrators from Herts & Essex Fertility Centre were delighted to meet with so many people at the Fertility Show at London Olympia last weekend. Now in its seventh year, the Fertility Show hosts a variety of professionals to provide an environment to enable individuals and couples to learn more about their fertility, to explore different treatment options and to gain valuable advice from experienced professionals, both on the exhibition floor and through a series of seminars given by selected speakers.
I was thrilled to have been invited to speak at The Fertility Show this year, and even more excited that the title provided for the seminar was to be exploring ‘New Technologies in IVF’ and I took the opportunity to talk about a subject that I am passionate about – sperm!
Selecting the strongest embryo for transfer is clearly of great importance within a treatment cycle and at Herts & Essex Fertility Centre we run a very successful blastocyst transfer programme enabling us to do so. However, sperm selection is also of fundamental importance so we have introduced an additional specialist technique to analyse the maturity of sperm within a sample.
So why is sperm maturity important? In a normal sperm sample, that vast majority of sperm will be mature. However, in some men there may be increased numbers of immature sperm. There are no differences in the ability of an immature or a mature to swim, nor are there differences in their shape (morphology). However, an immature sperm will not have completed its full development and is more likely to contain fragmented DNA, have abnormal chromosome numbers (aneuploidy) and poorer genetic integrity.
In natural fertilisation, an immature sperm will never be able to fertilise an egg. An immature sperm lacks the correct receptors which are necessary for it to bind to the cells surrounding the egg. It is the egg’s way of only allowing the sperm with the best genetic integrity to bind.
However, because we by-pass this natural selection during ICSI (the method in which sperm is injected directly into the egg to achieve fertilisation), there is a chance that an immature sperm may be inadvertently selected. An immature sperm can still achieve fertilisation but it is likely to result in a poorer quality embryo, which, if selected for transfer, has an increased likelihood of resulting in pregnancy loss.
At Herts & Essex Fertility we routinely assess the percentage of immature sperm within all our patient’s samples using a specialised microscope slide. This enables us to identify those men with increased proportions of sperm with poorer genetic integrity. If this is the case, we can help these patients by offering a technique known as PICSI (physiological intracytoplasmic sperm injection).
PICSI is a modified form of conventional ICSI whereby the embryologist is able to select only mature sperm for injection, ensuring that only sperm with good genetic integrity are used for fertilisation. PICSI can therefore benefit men with low levels of mature sperm and has been linked to better embryo quality, increased clinical pregnancy rates and decreased pregnancy loss rates.