Use of Hyaluronan in the Selection of Sperm for Intracytoplasmic Sperm Injection (ICSI): A Systematic Review and Meta-Analysis

Background: Studies on the effect of intracytoplasmic injection of hyaluronan-bound spermatozoa (HA-ICSI) on infertility are insufficient, and its use in treating patients remains controversial. Therefore, we aimed to determine the effectiveness of HA-ICSI in couples with infertility. Methods: A sys...

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Main Authors: Wei Fan, Weixia Guo, Qiong Chen
Format: Article
Language:English
Published: IMR Press 2024-06-01
Series:Clinical and Experimental Obstetrics & Gynecology
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Online Access:https://www.imrpress.com/journal/CEOG/51/6/10.31083/j.ceog5106147
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author Wei Fan
Weixia Guo
Qiong Chen
author_facet Wei Fan
Weixia Guo
Qiong Chen
author_sort Wei Fan
collection DOAJ
description Background: Studies on the effect of intracytoplasmic injection of hyaluronan-bound spermatozoa (HA-ICSI) on infertility are insufficient, and its use in treating patients remains controversial. Therefore, we aimed to determine the effectiveness of HA-ICSI in couples with infertility. Methods: A systematic literature review and meta-analysis were conducted to explore the effect of HA-ICSI on couples with infertility. All studies were examined using relative risks (RR) with 95% confidence intervals (95% CI). Results: A total of 1174 publications were retrieved, of which 16 (10 randomized controlled trials (RCTs), five cohort trials, and one publication, including an RCT and a cohort trial) were considered eligible for inclusion. Meta-analysis of the cohort studies indicated a significant advantage for HA-ICSI in terms of live birth rate (LBR), clinical pregnancy rate (CPR), biochemical pregnancy rate (BPR), implantation rate (IR), fertilization rate (FR), and good-quality embryo rate. No difference in spontaneous abortion rate (SAR) or cleavage rate between the HA-ICSI and conventional intracytoplasmic sperm injection (ICSI) groups was observed. Based on the pooled results of all available studies and RCTs, SAR was significantly reduced in the HA-ICSI group than in the conventional ICSI group. The benefits of CPR, IR, and FR were recognized in the pooled results of all available studies; however, RCT analysis did not demonstrate these benefits. Conclusions: The cohort studies indicated a significant advantage of HA-ICSI in terms of LBR, CPR, BPR, IR, FR, and good-quality embryo rates. In RCTs, HA-ICSI significantly reduced the SAR compared to conventional ICSI. Further RCTs with larger sample sizes are required to confirm the beneficial effects of HA-ICSI.
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spelling doaj-art-a27db2023b3041a0979dd21bc773375d2025-08-20T03:19:57ZengIMR PressClinical and Experimental Obstetrics & Gynecology0390-66632024-06-0151614710.31083/j.ceog5106147S0390-6663(24)02371-6Use of Hyaluronan in the Selection of Sperm for Intracytoplasmic Sperm Injection (ICSI): A Systematic Review and Meta-AnalysisWei Fan0Weixia Guo1Qiong Chen2Department of Obstetrics and Gynaecology, West China Second Hospital, Sichuan University, 610041 Chengdu, Sichuan, ChinaDepartment of Obstetrics and Gynaecology, West China Second Hospital, Sichuan University, 610041 Chengdu, Sichuan, ChinaKey Laboratory of Birth Defects and Related Diseases of Women and Children, Ministry of Education, Sichuan University, 610041 Chengdu, Sichuan, ChinaBackground: Studies on the effect of intracytoplasmic injection of hyaluronan-bound spermatozoa (HA-ICSI) on infertility are insufficient, and its use in treating patients remains controversial. Therefore, we aimed to determine the effectiveness of HA-ICSI in couples with infertility. Methods: A systematic literature review and meta-analysis were conducted to explore the effect of HA-ICSI on couples with infertility. All studies were examined using relative risks (RR) with 95% confidence intervals (95% CI). Results: A total of 1174 publications were retrieved, of which 16 (10 randomized controlled trials (RCTs), five cohort trials, and one publication, including an RCT and a cohort trial) were considered eligible for inclusion. Meta-analysis of the cohort studies indicated a significant advantage for HA-ICSI in terms of live birth rate (LBR), clinical pregnancy rate (CPR), biochemical pregnancy rate (BPR), implantation rate (IR), fertilization rate (FR), and good-quality embryo rate. No difference in spontaneous abortion rate (SAR) or cleavage rate between the HA-ICSI and conventional intracytoplasmic sperm injection (ICSI) groups was observed. Based on the pooled results of all available studies and RCTs, SAR was significantly reduced in the HA-ICSI group than in the conventional ICSI group. The benefits of CPR, IR, and FR were recognized in the pooled results of all available studies; however, RCT analysis did not demonstrate these benefits. Conclusions: The cohort studies indicated a significant advantage of HA-ICSI in terms of LBR, CPR, BPR, IR, FR, and good-quality embryo rates. In RCTs, HA-ICSI significantly reduced the SAR compared to conventional ICSI. Further RCTs with larger sample sizes are required to confirm the beneficial effects of HA-ICSI.https://www.imrpress.com/journal/CEOG/51/6/10.31083/j.ceog5106147hyaluronanintracytoplasmic sperm injectionsperm electionmeta-analysis
spellingShingle Wei Fan
Weixia Guo
Qiong Chen
Use of Hyaluronan in the Selection of Sperm for Intracytoplasmic Sperm Injection (ICSI): A Systematic Review and Meta-Analysis
Clinical and Experimental Obstetrics & Gynecology
hyaluronan
intracytoplasmic sperm injection
sperm election
meta-analysis
title Use of Hyaluronan in the Selection of Sperm for Intracytoplasmic Sperm Injection (ICSI): A Systematic Review and Meta-Analysis
title_full Use of Hyaluronan in the Selection of Sperm for Intracytoplasmic Sperm Injection (ICSI): A Systematic Review and Meta-Analysis
title_fullStr Use of Hyaluronan in the Selection of Sperm for Intracytoplasmic Sperm Injection (ICSI): A Systematic Review and Meta-Analysis
title_full_unstemmed Use of Hyaluronan in the Selection of Sperm for Intracytoplasmic Sperm Injection (ICSI): A Systematic Review and Meta-Analysis
title_short Use of Hyaluronan in the Selection of Sperm for Intracytoplasmic Sperm Injection (ICSI): A Systematic Review and Meta-Analysis
title_sort use of hyaluronan in the selection of sperm for intracytoplasmic sperm injection icsi a systematic review and meta analysis
topic hyaluronan
intracytoplasmic sperm injection
sperm election
meta-analysis
url https://www.imrpress.com/journal/CEOG/51/6/10.31083/j.ceog5106147
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