Evaluation of the Effect of HOS Test on Asthenozoospermia Patients and ICSI Outcomes/ Karim Tawfik Ahmed Fayed ; Supervisors: Prof. Dr. Abdel Wahab El Ghareeb, Dr. Heba Ali Abdel El Rahman, Prof. Mostafa Fouad Gomaa.

Thesis (M.Sc.) -Cairo University, 2023.

Bibliography: pages 106-139.

In vitro fertilization (IVF) technique that involves injecting a
single sperm cell directly into the cytoplasm of an egg. This method is
used to prepare gametes for the creation of embryos that will be
transferred to the mother's uterus. In natural sperm selection in humans
is a rigorous process resulting in the highest quality sperm reaching,
and having an opportunity to fertilize the oocyte. In ICSI or IVF the
male partner provides a sperm sample on the same day when the eggs
are collected .
Before to ICSI, sperm selection and capacitation in vitro must
be completed. This apart from the most popular in vitro sperm
capacitation techniques (swim-up, simple wash, filtration, and density
gradients) certain recent techniques are extremely effective and
stronger to the previous ones.
ICSI has been proven to show the same efficiencies as in vitro
fertilization (IVF), a simpler technique where the oocytes, after pickup, are left with the prepared sperm sample overnight and fertilization
occurs following a sort of natural sperm selection . Nowadays, ICSI is
the most used technique infertility treatments in developed countries,
replacing IVF as the first choice .
ICSI is nowadays widely used in couples with severe male-factor
infertility and it is extensively demonstrated that it improves the
fertilization and pregnancy rates when motile spermatozoa are used.
However, for patients with complete asthenozoospemia, although reported
in only 1 of 5000 men, fertility prognosis is very poor, even with ICSI.so
 Summary
104
we use Hos test as method of sperm selection in male partner have poor
motility and consider as asthenospermia patient according to WHO 2021
6
TH Edition.
Conclusion In this study we evaluate the HOST Effect on
Asthenozoospermia Patients and Intra cytoplasmic Sperm Injection
Outcomes.
The HOS Test: Hypo-osmotic swelling test is economical test
which helps in the evaluation of the structural and functional integrity
of spermatozoa. It‘s based on the principle of liquid transports across
the cell membrane under hypo osmotic conditions to get the
equilibrium on both sides of cell membrane .This behavior is frequently
referred to as "tail curling." The ballooning of the plasma membrane is
what causes the curl.
The plasma membrane of the sperm is examined using the HOS
test to ascertain its structural integrity. The experiment is based on the
observation that under hypo-osmotic conditions, fluid can move across
an intact cell membrane before the cell's interior and outside are at
equilibrium. The cell will enlarge as a result of the fluid inflow,
pushing the plasma membrane outward. Normally, the plasma
membrane forms a tight seal around the fibers (axonemal complex) of
the sperm tail. Curling or bending of the tail fibers within the plasma
membrane will take place when the plasma membrane expands under
hypo-osmotic conditions. HOS Test is based on the swelling ability of
functioning sperms after being exposed to the hypo osmotic solution.
 Summary
105
Spermatozoa with defected in function of cell membrane do not swell
and their tails do not invagination.
The results of comparison outcome of HOS and NO HOS
test of sperm selection in ICSI cycles: This study carried on 100
patients in ICSI cycles according to Inclusion criteria where ages of
males and females with good hormonal profile, Males with reduced
sperm motility asthenospermia patient confirmed diagnosis with
infertility and Patients with HOS test positive semen profile. Statistics
of the results showed there was no significant difference between the
HOS and NO HOS groups regarding the fertilization rates, blastulation
quality and pregnancy outcomes (67.7 % VS 72.4%; 70.8% VS 60.9%
and 40% VS 34% respectively). However, no statistical significant
difference between the HOS and no HOS groups regarding oocytes
injected (P =0.001) almost equally oocytes number in ICSI, to avoid
any factors which may affect the results. After this statistics, we
obtained that HOS has better results than NO HOS test in terms of
embryos quality, grade A embryos and pregnancy outcomes. Therefore,
if broader, multi-infertility center randomized studies confirm these
favorable impacts on embryo quality and ICSI outcomes, HOS could be
thought of as the best routine on a regular basis for sperm selection
before ICSI. Finally we have achieved our main goal from the study;
which is getting the best protocol for sperm selection in ICSI which
give the best embryos quality for embryo transfer and increase
pregnancy rate in cases of infertility.

تقنية الإخصاب في المختبر (IVF) التي تتضمن حقن خلية منوية واحدة مباشرة في سيتوبلازم البويضة. تستخدم هذه الطريقة لتحضير الأمشاج لتكوين الأجنة التي سيتم نقلها إلى رحم الأم. الهدف من العمل: لتقييم تأثير العائل على مرضى استسقاء النطاف ونتائج حقن الحيوانات المنوية داخل السيتوبلازم. المريض والطرق: أجريت هذه الدراسة على 100 مريض في دورات الحقن المجهري وفقًا لمعايير التضمين حيث أكدت أعمار الذكور والإناث ذوي المظهر الهرموني الجيد والذكور الذين يعانون من ضعف حركة الحيوانات المنوية ومرضى وهن النطاف تشخيصهم بالعقم والمرضى الذين يعانون من اختبار HOS إيجابية للسائل المنوي. النتائج: لم يكن هناك فرق معتد به بين مجموعتي HOS و NO HOS فيما يتعلق بمعدلات الإخصاب وجودة التفجير ونتائج الحمل (67.7٪ مقابل 72.4٪ ؛ 70.8٪ مقابل 60.9٪ و 40٪ مقابل 34٪ على التوالي). ومع ذلك ، لا يوجد فرق ذو دلالة إحصائية بين مجموعات HOS وعدم وجود مجموعات HOS فيما يتعلق بالبويضات المحقونة (P = 0.001) عدد البويضات بشكل متساوٍ تقريبًا في الحقن المجهري ، لتجنب أي عوامل قد تؤثر على النتائج. الخلاصة: HOS له نتائج أفضل من اختبار NO HOS من حيث جودة الأجنة. أجنة الصف A ونتائج الحمل. لذلك ، إذا أكدت الدراسات العشوائية الأوسع نطاقاً في مركز العقم المتعدد هذه التأثيرات الإيجابية على جودة الجنين ونتائج الحقن المجهري ، يمكن اعتبار HOS أفضل روتين على أساس منتظم لاختيار الحيوانات المنوية قبل الحقن المجهري. أخيرًا لقد حققنا هدفنا الرئيسي من الدراسة ؛ وهو الحصول على أفضل بروتوكول لاختيار الحيوانات المنوية في الحقن المجهري والذي يعطي أفضل جودة للأجنة لنقل الأجنة ويزيد من معدل الحمل في حالات العقم.

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Text in English and abstract in Arabic & English.