Comparison of two ready-to-use systems designed for sperm-hyaluronic acid binding selection before intracytoplasmic sperm injection: PICSI vs. Sperm Slow: a prospective, randomized trial

Objective: To compare, in a strict, randomized way, the efficiency of two ready-to-use systems for hyaluronic acid (HA)-intracytoplasmic sperm injection (ICSI): an HA culture dish (PICSI Sperm Selection Device) and a viscous medium containing HA (Sperm Slow). Design: Prospective, randomized study. Setting: Medical center. Patient(s): Fifty subjects per treatment group (100 total). Intervention(s): One hundred ICSI treatments were randomly carried out with PICSI or with Sperm Slow for sperm selection. Randomization was conducted with sealed envelopes. Intracytoplasmic sperm injection was performed by a single embryologist with 5 years' experience in HA-ICSI. Main Outcome Measure(s): Primary outcome measure: good-quality embryo rate. Secondary outcome measures: oocyte fertilization, pregnancy and implantation rate, and the duration of the ICSI procedure. Result(s): The good-quality embryo rate was comparable between the two groups (58.5% with PICSI vs. 56% with Sperm Slow). Overall there were no statistically significant differences in secondary outcome measures except ICSI procedure duration, which was 3 minutes longer in the PICSI group. Conclusion(s): Both PICSI and Sperm Slow allow comparable clinical efficiency in selecting HA-bound spermatozoa. Clinical Trial Registration Number: ISRCTN72668039. (Fertil Steril (R) 2012; 98: 632-7. (C) 2012 by American Society for Reproductive Medicine.)