Abstract: Objective To explore the effects of sperm DNA integrity rate, acrosome integrity rate and acrosome reaction rate on
the outcomes of rescue intracytoplasmic sperm injection (ICSI). Methods This retrospective analysis was conducted among 97
infertile couples receiving rescue ICSI due to failure of in vitro fertilization procedures in our Reproductive Medicine Center.
Of these 97 women, 41 had clinical pregnancy and 56 did not, and the effects of sperm DNA integrity rate (estimated by DNA
fragmentation index, DFI), acrosome integrity rate and acrosome reaction rate on rescue ICSI outcomes were analyzed. Results
No significant difference was found in paternal age, testosterone value, testicular volume, FSH, female patient’ age or the
number of eggs retrieved between the two groups (P>0.05), but the infertility years was significantly shorter in the pregnancy
group than in the non-pregnancy group (P<0.05). The fertilization rate and cleavage rate were similar between the two groups
(P>0.05), but the good embryo rate was significantly higher in the pregnancy group (P<0.05). The sperm DNA integrity or
acrosome reaction rate did not differ significantly between the two groups (P>0.05), but the acrosome integrity rate was
significantly higher in the pregnancy group (P<0.05). The sperm DNA integrity rate, acrosome integrity or acrosome reaction
rate were not correlated with the fertilization rate, cleavage rate or good embryo rate (P>0.05). The pregnancy rate, twin and
single fetus rates were 42.3%, 10.3% and 32.0% in this cohort after recue ICSI, respectively. Conclusion Rescue ICSI is an
effective treatment after failed in vitro fertilization procedure, and sperm acrosome integrity rate is associated with the
outcome of rescue ICSI.