Outcome of Using Sperm Bound to the Zona Pellucida of Immature Oocytes for Intracytoplasmic Sperm Injection (ICSI)

In vivo, the zona pellucida (ZP) of the oocyte can bind to normally functional sperm. The ZP-sperm interaction is one of the final steps of natural selection during their journey in the female reproductive tract. In the current study, we evaluated the ability of the ZP of immature oocytes to harvest the fittest sperm. We compared the embryological outcomes of intracytoplasmic sperm injection (ICSI) using conventionally selected sperm (control group) and ZP-bound sperm (intervention group). Our results showed no statistically significant superiority for the ZP binding technique over the conventional sperm selection with respect to the rates of fertilization and cleavage. However; the rates of blastocyst formation and high-quality blastocysts were significantly improved in the intervention group compare to the control group. These findings imply that the proposed technique can serve as a cost-effective and natural sperm selection method that has the potential to enhance the embryological and clinical outcomes of intracytoplasmic sperm injection (ICSI).