A Comparison of ICSI Outcomes and Reactive Oxygen Species Levels in Seminal Plasma between Normozoospermia and Sperm Abnormalities Groups for Infertile Men

Background: Social life and the healthcare systems are affected by infertility. Infertility could be primary or secondary; secondary infertility is the inability to conceive after one successful pregnancy while primary infertility is the inability to conceive at all. As sperm abnormalities cause male infertility, Intracytoplasmic Sperm Injection (ICSI) is a particular type of in vitro fertilization (IVF) used to treat severe male-factor infertility. Free radical oxygen derivatives are reactive oxygen species (ROS). Reactive oxygen species may cause 30% to 80% of male infertility.  Aims of the study: the present study aims to determine the reactive oxygen species level in seminal plasma and to study the Intracytoplasmic Sperm Injection outcomes for Normospermia group and compare it with Oligozoospermia, Asthenozoospermia and the Teratozoospermia Groups.  Material, and Methods: a cross-sectional study was conducted between January 2023 to June 2023 in Najaf, on a non-random sampling including 50 couples who suffered from a minimum of 12 months of primary fertility with regular unprotected sexual intercourse and who had attended the fertility center in Najaf requesting fertility treatment. A gynecological examination and assessment were done for the female participants while the urologists examined and assessed the male subjects; then, a semen analysis was carried out followed by macroscopic and microscopic examinations. After the preparation of the sample for ICSI and performing ICSI, pregnancy was assessed and the outcomes of the different groups were compared. At the same time, reactive oxygen species levels were assessed by using the Human Reactive Oxygen Species ELISA kit. Then, the SPSS version 26 was used to perform the statistical analysis. Results: Among the twenty-one patients with Normozoospermia, seven with Asthenospermic, seven with Oligozoospermia and fifteen with Teratozoospermia,  there was a significant difference among the four groups regarding sperm concentration, progressive motility, and sperm normal morphology. There was no significant difference among the type of sperm, Normo, Astheno, Tearato, and Oligozoospermia, regarding birth rate and ICSI outcomes. Males with higher progressive motility showed a higher pregnancy rate. In conclusion, despite the presence of reactive oxygen species, Intracytoplasmic Sperm Injection was advantageous and effective for all four groups. reactive oxygen species had no significant effect on Intracytoplasmic Sperm Injection outcomes, however Normozoospermia was associated with greater pregnancy rates. Despite the presence of reactive oxygen species, Intracytoplasmic Sperm Injection was advantageous and effective for all four groups. ROS had no significant effect on Intracytoplasmic Sperm Injection outcomes, however Normozoospermia was associated with greater pregnancy rates.