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Use of zona pellucida‐bound spermatozoa as a natural selection in improvement of ICSI outcomes: A systematic review and meta‐analysis
Author(s) -
Izadi Mahin,
Khalili Mohammad Ali,
SalehiAbargouei Amin,
Rezvani Mohammad Ebrahim,
Aflatoonian Behrouz
Publication year - 2021
Publication title -
andrologia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.633
H-Index - 59
eISSN - 1439-0272
pISSN - 0303-4569
DOI - 10.1111/and.14022
Subject(s) - zona pellucida , andrology , pregnancy rate , sperm , selection (genetic algorithm) , medicine , pregnancy , biology , embryo , gynecology , oocyte , computer science , genetics , artificial intelligence
Zona pellucida (ZP)‐bound spermatozoa have normal morphology and motility and can enhance the ICSI outcomes. Selection of zona pellucida‐bound spermatozoa is recently considered to find functional spermatozoa for ICSI. This study reviewed the efficacy of ZP‐bound sperm selection on the ICSI outcomes includes fertilisation rate, embryo quality, embryo transfer rate and clinical pregnancy rate. The databases searched include PubMed, Scopus and Cochrane databases up to January 2019. All research reports with full text and in English language that addressing the relation between ZP‐sperm selection and ICSI outcomes were included. Fifty studies were suitable after screening of the 845 identified articles. After exclusions, five of these studies were included. Meta‐analytic pooling of data indicated no association between the ICSI outcomes and ZP‐bound sperm selection except a marginal effect on implantation rate. Eliminating one study indicated that ZP‐bound sperm selection technique improves embryo quality, implantation rate and clinical pregnancy rate. This study revealed that ZP‐bound sperm selection produces only a slight improvement in implantation rate. However, further studies with a large number of couples must be done to clarify the potential beneficial effect of ZP‐bound spermatozoa on ICSI outcomes.