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Abstract

Volume 23, Issue 1 (January 2021) 23, 11–15; 10.4103/aja.aja_18_20

The hamster egg penetration test may decrease intracytoplasmic sperm injection utilization while maintaining high conventional fertilization rates

Yetunde Ibrahim1, Brett Einerson2, Douglas T Carrell1,3,4, Benjamin R Emery3, Erica Johnstone1

1 Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, University of Utah, School of Medicine, Salt Lake City, UT 84132, USA
2 Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of Utah, School of Medicine, Salt Lake City, UT 84132, USA
3 Division of Urology, Department of Surgery, University of Utah, School of Medicine, Salt Lake City, UT 84132, USA
4 Department of Human Genetics, University of Utah, School of Medicine, Salt Lake City, UT 84132, USA

Correspondence: Dr. Y Ibrahim (yetunde.ibrahim@hsc.utah.edu)

Date of Submission 09-Dec-2019 Date of Acceptance 09-Mar-2020 Date of Web Publication 19-May-2020

Abstract

This was a cohort study of in vitro fertilization (IVF) subjects at the University of Utah, Salt Lake City (UT, USA) utilizing partner sperm. Cycles where both the hamster egg penetration test (HEPT) and semen analysis were performed within 2 years prior to IVF cycles were stratified into four groups based on a normal or an abnormal HEPT and morphology. The mean conventional and intracytoplasmic sperm injection (ICSI) fertilization rates were calculated in each group. We performed a univariate analysis on the primary outcome comparing clinically interesting subjects. We performed a cost-effectiveness analysis of a policy of HEPT
versus universal ICSI in couples with an abnormal morphology. Among patients with a normal HEPT, there was no difference in the mean conventional fertilization rates between those with a normal and an abnormal morphology. There was no difference in the mean conventional fertilization rates between subjects with a normal morphology without a hamster test and those with a normal HEPT without a morphology assessment. In 1000 simulated cycles with an abnormal morphology, a policy of HEPT was cost saving compared to universal ICSI, yet produced similar fertilization rates. The HEPT is similar to the World Health Organization edition 5 (WHO-5) morphology in predicting successful conventional fertilization while allowing decreased utilization of ICSI. A policy of HEPT for males with abnormal morphology saves cost in selecting couples for a fertilization method.

Keywords: conventional fertilization; hamster egg penetration test; intracytoplasmic sperm injection; semen analysis; sperm penetration assay

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