Zona Pellucida Bound Sperm vs. Embryologist Selected Sperm for Intracytoplasmic Sperm Injection

Inclusion Criteria:

• Undergoing their first in vitro fertilization (IVF) cycle

• Electing single embryo transfer

• Electing preimplantation genetic testing for aneuploidy (PGT-A) of their embryos

• Female partners age <42 years old at start of vaginal oocyte retrieval cycle, but >18 years old.

• Normal ovarian reserve:

• Antimullerian hormone level (AMH) ≥ 1.2 ng/mL

• Antral follicle count (AFC) ≥ 8

• At least 4 mature oocytes (M2s) retrieved at the VOR procedure in order to randomize

• At least 1 immature oocyteretrieved at the VOR procedure to perform ZP bindingco-incubation procedure

• Intention to transfer the morphological best quality, euploid, embryo at the frozenembryo transfer procedure

Exclusion Criteria:

• Contraindication to IVF

• Clinical indication for preimplantation genetic testing (i.e., screening for singlegene disorder, chromosomal translocation, or any other disorders requiring a moredetailed embryo genetic analysis)

• Male partner with azoospermia or oligozoospermia (<100,000 total motile spermatozoa)

• Male partner with Y-chromosome microdeletion

• Male partner with any Karyotype other than 46,XY

• Male partner requiring surgically obtained sperm either via testicular or epididymalretrieval procedures

• Uncorrected hydrosalpinges that communicate with the endometrial cavity

• Endometrial Insufficiency, as defined by a prior cycle with maximal endometrialthickness <6mm,), or persistent endometrial fluid

• Donor oocyte cycles

• Gestational carriers