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The treatment of male infertility with the help of a new IVF technique called PICSI, already offered in some private clinics, does not increase the likelihood of having a baby, according to the results of a randomized controlled trial.
During PICSI treatment, sperm cells were selected to fertilize eggs based on their ability to bind to hyaluronan, a substance normally found around the surface of eggs.
During a trial involving more than 2,700 couples across the UK, researchers examined the impact of hyaluronan on the success rate of treating male infertility. after injection of selected spermatozoa by PICSI into the egg.
Led by the University of Leeds, the study revealed no significant difference in term live births using the new PICSI technique, with a success rate of about one in four couples for PICSI treatment and standard ICSI treatment.
Posted in The lancetThe study was the largest randomized controlled trial evaluating whether PICSI would lead to more live births than current techniques, providing vital evidence to help guide clinics and couples making decisions regarding the treatment of male infertility.
Although PICSI treatment does not significantly increase the number of live births, researchers find that it significantly reduces the number of miscarriages by 39% overall (4.3%). couples under PICSI suffered a miscarriage compared to 7.0% under ICSI).
Couples involved in the trial were randomly badigned to either the standard ICSI treatment or the new, more costly, PICSI treatment that is already offered in some fertility clinics, despite the lack of evidence that they are being tested. it increases success rates.
Lead author Dr. David Miller, an andrologist at Leeds University, said: "ICSI treatment is currently used by millions of couples around the world and is becoming the dominant treatment for infertility in many places Therefore, any improvement in the technique has the potential to create a widespread positive impact.
"However, our findings suggest that more work is needed to refine and improve PICSI before it is more widely recommended to treat infertility.
"This trial paved the way for new research focused on miscarriage and how sperm selected by hyaluronan can reduce the impact of this devastating result."
The study was funded by the EME program – a partnership between the Medical Research Council (MRC) and the National Institute for Health Research (NHRI) – and supported by the INDH Yorkshire Clinical Research Network. and Humber.
Co-author Yakoub Khalaf, medical director and consultant gynecologist at the NHS Trust Foundation in St Thomas and Thomas, said: "Couples can be forced to consider additions and other techniques giving them additional hope and expectations for successful treatment, but it is important that good evidence supports their use.
"We hope these new discoveries will help couples who are considering IVF to choose which treatments to choose.
"The success rates of IVF have remained at around 25% of all treatment cycles over the past decade, so it's vital to continue to develop new and effective techniques to improve success rates."
Led by the University of Leeds, the clinical trial was coordinated by Queen Mary University in London and involved sixteen fertility centers in England and Scotland, as well as the Royal College of Obstetricians and Gynecologists and the Examination Limited .
Professor David Crossman, Chair of the EME Funding Committee, said, "We are pleased to be able to support such quality research on critical medical interventions.
"This study gives more power to decision-making in the field of IVF thanks to the thoroughness with which it was conducted.The authors have shown that the new treatment has little benefit.In helping patients in their decisions, these researchers also stressed the urgent need to continue work in this important area. "
Treatment with PICSI is different from the complementary addition of "embryo glue" generally proposed for IVF treatment, since PICSI involves preselecting sperm depending on whether it binds itself or not to hyaluronan. The "embryo glue" implies that the fertilized embryos are covered with hyaluronan to increase their chances of implantation in the uterus.
IVF is used to treat female and male infertility, which each account for about half of the visits to IVF clinics for badisted procreation. During the treatment of male infertility, embryologists manually choose the best sperm with which to fertilize an egg, at sight for ICSI and in conjunction with hyaluronan for PICSI, since the sperm would be less able to cause a natural pregnancy.
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Notes to editors
For any interview requests, please contact Simon Moore, press officer at the University of Leeds, at 0113 34 38059 or at [email protected].
The lancet The document titled "A randomized clinical trial on intracytoplasmic sperm injection (PICSI) physiologically selected hyaluronan for the treatment of infertility (HABSelect)". and will be available online here: http://www.thelancet.com/journals/lancet/ article / PIIS0140-6736 (18) 32989-1 / full text
University of Leeds
The University of Leeds is one of the largest higher education institutions in the UK, with more than 38,000 students from more than 150 different countries, and a member of the Russell Group of Universities with strong research intensity. The University plays an important role in the Turing Institutes, Rosalind Franklin and Royce.
According to the 2014 Research Excellence Framework, we are one of the top ten universities in the UK for research and impact in the UK, and we figure in the top 100 in the QS World University Rankings 2019.
In 2017, the government's Gold Teaching Excellence Framework awarded the Gold Award, recognizing its always outstanding "teaching and learning" offerings. Twenty-six of our scholars have received national scholarships – more than any other institution in England, Northern Ireland, and Wales – reflecting the excellence of our teaching. http: // www.
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MRC and NIHR
The study was funded by a partnership between the CRM and the NHRI created to support the evaluation of interventions that could radically alter health promotion, disease treatment, and treatment. Improvement of rehabilitation or long-term care.
1. The National Institute of Health Research (IRD): improve the health and wealth of the country through research. Created by the Ministry of Health and Social Services, NIHR:
- Funding, support and high-quality research relevant to the NHS, public health and social care
- Involve and involve patients, caregivers and the public to improve the reach, quality and impact of research
- Attracts, trains and supports the best researchers to face the complex challenges of the future in health and care
- Invests in world-clbad infrastructure and qualified delivery personnel to translate discoveries into improved treatments and services
- Collaborate with other public funders, charities and the sector to maximize the value of research for patients and the economy
NIHR was created in 2006 to improve the health and wealth of the country through research. It is funded by the Ministry of Health and Social Affairs. In addition to its national role, the NHRI directs applied health research to benefit the poorest people in low- and middle-income countries, using official development badistance funding.
2. The Council for Medical Research is at the forefront of scientific discoveries aimed at improving human health. Founded in 1913 to fight tuberculosis, the MRC now invests taxpayers' money in one of the best medical research in the world in all areas of health. Thirty-three researchers funded by the MRC have won Nobel Prizes in a wide range of disciplines. MRC scientists have been behind discoveries as diverse as vitamins, the structure of DNA and the link between smoking and cancer, as well as achievements such as the use of # 39; randomized controlled trials, the invention of MRI and the development of a group of antibodies used in the manufacture of some of the most effective drugs ever developed. Today, MRC-funded scientists are addressing some of the most serious health problems facing humanity in the 21st century, from the growing wave of chronic diseases badociated with aging to the age of 19. the threats posed by rapidly changing micro-organisms. The Medical Research Council is part of UK Research and Innovation. https: /
This work uses data provided by patients and collected by the NHS as part of their care and support and would not have been possible without access to this data. NIHR recognizes and values the role of patient data, which is securely accessed and stored, both to support and improve research and care. http: // www.
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