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Background : Intracytoplasmic sperm injection (ICSI) has risen to the forefront of reproductive technology. In the present study, the location of the sperm injection was noted, and a prospective study was conducted to evaluate the effect of the sperm retention site on cleavage rates and embryo quality after ICSI. Methods : This study involved 336 ICSI patients (age 27–44; average 37.4) where 1545 oocytes were observed. An oocyte was divided into nine sites and the sperm retention site was observed microscopically after injection. The polar body was placed at either the twelve or six o’clock position. The injection pipette was introduced at the three o’clock position and oolemma rupture was ascertained by mild suction. The main outcome measures were the relationship of sperm remaining in position in the oocyte to fertilization rate and embryo quality. Results : When the injection pipette was introduced at the three o’clock position, about 80% of the sperm remained in the center or left of center. The fertilization rate was significantly lower (p < 0.05) when the sperm remained near the site of introduction. Embryo quality was not significantly affected by the sperm retention site. Conclusions : About 12–14% of the spermatozoa remained near the introducing position, and in these cases the fertilization rate was low. However, once fertilization occurred, the sperm retention site had minimal impact on embryo quality. Injecting sperm near the spindle site may improve embryo quality.

The purpose of this study was to predict developmental competence of human oocytes during ICSI via analysis of connexin 43 (Cx43) in cumulus cells surrounding mature oocytes.Human cumulus cells were manually separated from the oocyte-cumulus complex under a microscope. Cx43 mRNA was expressed by real-time quantitative polymerase chain reaction (RT-PCR) measurement in cumulus cells.There was no significant relationship between expression of Cx43 and fertilisation or cleavage rate. However, Cx43 expression was lower in the good morphology group (blastomeres7 cells with fragmentation10% on day 3) when compared to the other groups (p=0.035).These results suggest that full reduction of Cx43 expression on cumulus cells at the time of oocyte collection during ICSI is essential for developmental competence of human oocytes.