Orientador: Maria Yolanda Makuch / Tese (doutorado) - Universidade Estadual de Campinas, Faculdade de Ciencias Medicas / Made available in DSpace on 2018-11-09T15:39:47Z (GMT). No. of bitstreams: 1 Filetto_JulianaNicolau_D.pdf: 899402 bytes, checksum: b505244b4e512938da35a1ca1479c305 (MD5) Previous issue date: 2009 / Resumo: Objetivo: Descrever as vivências de homens e mulheres ao estarem iniciando os procedimentos de fertilização in vitro (FIV) e em longo prazo após o fracasso da terapêutica. Metodologia: Para cumprir com os objetivos propostos foram feitos dois estudos qualitativos, ambos realizados no Ambulatório de Reprodução Humana do Departamento de Tocoginecologia da Faculdade de Ciências Médicas (UNICAMP). Para o primeiro estudo foi escolhida uma amostra proposital por variedade de tipos - casais sem filhos, com filhos e que a mulher tinha filhos de um relacionamento anterior - que tinham realizado a FIV sem sucesso quatro a sete anos antes de serem entrevistados. O número de participantes foi definido conforme o critério de saturação da informação. Foram conduzidas entrevistas semi-estruturadas utilizando-se um roteiro temático, as quais foram gravadas e transcritas. Para o segundo estudo foi realizada uma re-análise das entrevistas de casais sem filhos realizadas quatro a seis anos após o fracasso da FIV do estudo acima e de casais sem filhos, que estavam iniciando pela primeira vez ou repetindo os procedimentos da FIV de outro estudo. O número de entrevistas analisadas foi definido conforme o critério de saturação da informação. Resultados: No primeiro estudo, homens e mulheres consideraram a FIV como uma experiência válida, apesar de alguns terem vivenciado dificuldades no relacionamento conjugal após o fracasso, as quais foram sendo superadas em longo prazo. Em relação às etapas do procedimento, alguns participantes se referiram ao desenvolvimento folicular como uma etapa difícil e dolorida e alguns acreditavam que a medicação tinha causado mudanças permanentes no corpo das mulheres. Os homens referiram a etapa da coleta do sêmen como uma experiência desconfortável. Após o fracasso da FIV, a maioria dos casais considerou a possibilidade da adoção, porém poucos adotaram e outros participantes se dedicaram a novos projetos de vida que não fosse o de terem um filho. Casais sem filhos decidiram realizar novas tentativas de FIV em outros serviços devido a necessidade de continuarem tentando. No segundo estudo, ao se contrapor as vivências de homens e mulheres, iniciando os procedimentos e em longo prazo, os participantes falaram que a decisão tinha sido baseada principalmente na certeza de sucesso e algumas mulheres mencionaram a necessidade de serem iguais às "mulheres férteis". Nas entrevistas dos homens, tanto no início do procedimento como em longo prazo, foi observado que a decisão tinha sido mais influenciada pelo desejo das parceiras pela gravidez. Em relação às etapas da FIV, as mulheres que estavam iniciando o procedimento, referiram as injeções de hormônios como preocupante, e em longo prazo, as consideraram doloridas e algumas, semelhante ao resultado do primeiro estudo, também acreditavam que a medicação tinha causado mudanças permanentes em seus corpos. Os homens, em geral, falaram da preocupação com a possível repercussão dos medicamentos na saúde da parceira. Algumas mulheres, tanto iniciando como em longo prazo, tinham a percepção de que a coleta do sêmen não tinha incomodado os parceiros. A mesma percepção foi mencionada pela maioria dos homens iniciando os procedimentos, embora a lembrança que prevaleceu em longo prazo foi a de ter sido uma experiência tensa e constrangedora. Conclusão: Homens e mulheres, devido à esperança pela gravidez, tendem a não se incomodarem com as exigências dos procedimentos, o que não ocorreu após o fracasso da FIV. Em longo prazo, homens e mulheres consideraram os procedimentos da FIV como uma experiência positiva e foram capazes de se dedicarem a outros projetos de vida, os quais foram considerados satisfatórios, exceto para os casais sem filhos. / Abstract: Objective: To describe the life experience of men and women at the beginning and after unsuccessful in vitro fertilization (IVF) procedures. Methods: Two qualitative studies were conducted to achieve the proposed aims, at the Department of Obstetrics and Gynecology, School of Medical Sciences, University of Campinas (UNICAMP). Participants for the first study were chosen using a purposive sampling per variety of types - couples without children, couples who already had children and wished to have another child, and couples in which the women had children from a previous relationship - that had experienced unsuccessful IVF four to seven years before the interviews. The number of interviews carried out was defined according to the criteria of information saturation. Semi-structured interviews were conducted using a thematic script, which were tape-recorded and transcribed. The second study was based on the re-analysis of the interviews of couples without children interviewed four to six years after an unsuccessful IVF from the study above and couples without children interviewed at the beginning of the procedures the first time they were participating or when repeating IVF from a previously conducted study. The number of interviews carried out was defined according to the criteria of information saturation. Results: In the first study, men and women considered IVF a positive experience, even though some couples recalled difficulties in their relationship after unsuccessful IVF, however they felt that their marital relationship had not been permanently affected. Regarding the stages of the procedure, some participants recalled follicular development as a difficult and painful stage in the treatment and some believed that the medication used during that phase had resulted in body changes, in some cases considered permanent. The men referred to semen collection as an uncomfortable experience. The majority of the couples had considered adoption, but only a few couples actually adopted and others participants had focused on new life projects other than having children. Couples who had no children recalled they had pursued treatment in other clinics due to the necessity to keep trying. In the second study, comparing men and women's life experiences at the beginning of the procedures and in the long-term, all participants recalled that their decision to undergo IVF had been based principally on the certainty of success, and some women referred to their need to be like "a fertile women". In men's interviews, at the beginning of procedures and in the long-term, it was observed that the decision to participate in IVF procedures had been mainly based on woman's desire of pregnancy. Regarding the stages of the procedures, women who were beginning the procedures referred the hormone injections as preoccupying and in the long term they remembered as painful stage and some, similar to the results of the first study, believed that had resulted in permanent body changes. Men, in general, referred to worries about the possible repercussion of the medicines used during this stage in their partner's health. Some women in the beginning and in long-term, had the perception that semen collection was not a stressful experience for the partners. A similar perception was mentioned by the majority of men beginning the procedures, although in the long term their recollection was of a stressful and embarrassing experience. Conclusion: Men and women due the hope for the pregnancy tend not to be bothered with the requirements of the procedures, different of what happened after IVF failure. In long-term, men and women, considered IVF procedures as a positive experience and were able to focus on other life projects, which were considered satisfactory, except for the couples without child. / Doutorado / Ciencias Biomedicas / Doutor em Tocoginecologia

Research report submitted in accordance with the requirements for the Degree Master of Science in Medicine( Bioethics and Health Law. Faculty of Health Sciences, University of the Witwatersrand Steve Biko Centre for Bioethics, 2014 / It is every normal parent’s wish to have a happy child free of ailments and suffering. However, not all children are born free of diseases and suffering. Some are born with severe disabilities and others are born with congenital genetic problems that have less chances of cure or no cure at all. These unfortunate circumstances make parents of such children with severe medical conditions desperate and devastated to the extent that they try anything possible in attempting to improve quality of life of their sick children. No parent wants to see his or her child suffering. However, a more pressing situation is when parents decide to have a second child whose purpose is to save the life of the sick first child by donating stem cells from cord blood or bone marrow. This second child is sometimes referred to as the “Saviour sibling” and is born for the purpose of saving the life of the sick older child of the family. ‘Saviour sibling is the media name for a child who is conceived, gestated, and delivered in order to provide umbilical cord blood, or, even more contentious, bone marrow desperately needed by the parents’ older child’ (Mills 2005:2).Because there is no matching donor for the ill older child, a donor is created in the form of a second sibling, whose match is genetically guaranteed by IVF, preimplantation genetic diagnosis (PGD), and tissue typing (Boyle and Savulescu 2001). Given that children are already being created in other Countries such as the United States of America, France and Britain for the above-mentioned purpose, this research report will attempt to engage in the debate surrounding saviour siblings, the use of preimplantation genetic diagnosis (PGD) in creating these children, and the possibility of this technology being abused and misused for gender selection. Taking this into consideration, this research report will attempt to highlight what the South African laws and policies say about saviour siblings. Should parents with pressing issues as mentioned-above demand to have a “saviour child” of their own for the purpose of using him or her to save the life of another of their children in South Africa, on which grounds would it be rejected or accepted?

O presente estudo buscou compreender os percursos singulares rumo à paternidade no contexto da reprodução assistida, desde a gestação até o primeiro ano de vida do(s) bebê(s). Foi realizado um estudo de caso coletivo longitudinal. Participaram três homens que se submeteram, junto com as esposas, à fertilização in vitro, sendo a causa da infertilidade masculina ou mista. Os pais responderam entrevistas semiestruturadas em três momentos: a) terceiro trimestre de gestação; b) terceiro mês de vida do(s) bebê(s); e c) final do primeiro ano de vida do(s) bebê(s). Os percursos singulares foram relatados e analisados a partir da metodologia do relato clínico. Buscou-se, a partir daí, (re)construir esses três percursos, com seus desafios singulares de elaboração e integração da experiência da paternidade, bem como os desafios no percurso da pesquisadora. Pode-se perceber a solidão dos homens que passaram pela experiência da infertilidade e do tratamento, especialmente por eles terem referido que cuidaram mais do que se sentiram cuidados. Destaca-se a importância de se oferecer um espaço de escuta para esses homens, não só em uma situação de pesquisa, mas também na prática do profissional de saúde mental que trabalha nesse contexto. / This study investigated the unique pathways toward fatherhood in the context of assisted reproduction, from pregnancy to the first year of the babies’ lives. A collective longitudinal case study was conducted. Participants were three men who had undergone, along with their wives, in vitro fertilization. The cause of their infertility was male or mixed. Fathers answered semi-structured interviews in three moments: a) third trimester of pregnancy; b) their babies’ third month of life; c) their babies’ first year of life. The unique pathways have been reported and analyzed based on the clinical report methodology. These three pathways were (re)constructed, with their unique challenges concerning elaboration and integration of fatherhood experience, as well as the researcher’s challenges. Loneliness could be felt in the reports of men who have experienced infertility and treatment. They said they cared more than were cared for. The importance of providing a space for listening to these men is emphasized, not only in a research situation, but also in the practice of mental health professionals who work in this context.

O presente estudo buscou compreender os percursos singulares rumo à paternidade no contexto da reprodução assistida, desde a gestação até o primeiro ano de vida do(s) bebê(s). Foi realizado um estudo de caso coletivo longitudinal. Participaram três homens que se submeteram, junto com as esposas, à fertilização in vitro, sendo a causa da infertilidade masculina ou mista. Os pais responderam entrevistas semiestruturadas em três momentos: a) terceiro trimestre de gestação; b) terceiro mês de vida do(s) bebê(s); e c) final do primeiro ano de vida do(s) bebê(s). Os percursos singulares foram relatados e analisados a partir da metodologia do relato clínico. Buscou-se, a partir daí, (re)construir esses três percursos, com seus desafios singulares de elaboração e integração da experiência da paternidade, bem como os desafios no percurso da pesquisadora. Pode-se perceber a solidão dos homens que passaram pela experiência da infertilidade e do tratamento, especialmente por eles terem referido que cuidaram mais do que se sentiram cuidados. Destaca-se a importância de se oferecer um espaço de escuta para esses homens, não só em uma situação de pesquisa, mas também na prática do profissional de saúde mental que trabalha nesse contexto. / This study investigated the unique pathways toward fatherhood in the context of assisted reproduction, from pregnancy to the first year of the babies’ lives. A collective longitudinal case study was conducted. Participants were three men who had undergone, along with their wives, in vitro fertilization. The cause of their infertility was male or mixed. Fathers answered semi-structured interviews in three moments: a) third trimester of pregnancy; b) their babies’ third month of life; c) their babies’ first year of life. The unique pathways have been reported and analyzed based on the clinical report methodology. These three pathways were (re)constructed, with their unique challenges concerning elaboration and integration of fatherhood experience, as well as the researcher’s challenges. Loneliness could be felt in the reports of men who have experienced infertility and treatment. They said they cared more than were cared for. The importance of providing a space for listening to these men is emphasized, not only in a research situation, but also in the practice of mental health professionals who work in this context.

O presente estudo buscou compreender os percursos singulares rumo à paternidade no contexto da reprodução assistida, desde a gestação até o primeiro ano de vida do(s) bebê(s). Foi realizado um estudo de caso coletivo longitudinal. Participaram três homens que se submeteram, junto com as esposas, à fertilização in vitro, sendo a causa da infertilidade masculina ou mista. Os pais responderam entrevistas semiestruturadas em três momentos: a) terceiro trimestre de gestação; b) terceiro mês de vida do(s) bebê(s); e c) final do primeiro ano de vida do(s) bebê(s). Os percursos singulares foram relatados e analisados a partir da metodologia do relato clínico. Buscou-se, a partir daí, (re)construir esses três percursos, com seus desafios singulares de elaboração e integração da experiência da paternidade, bem como os desafios no percurso da pesquisadora. Pode-se perceber a solidão dos homens que passaram pela experiência da infertilidade e do tratamento, especialmente por eles terem referido que cuidaram mais do que se sentiram cuidados. Destaca-se a importância de se oferecer um espaço de escuta para esses homens, não só em uma situação de pesquisa, mas também na prática do profissional de saúde mental que trabalha nesse contexto. / This study investigated the unique pathways toward fatherhood in the context of assisted reproduction, from pregnancy to the first year of the babies’ lives. A collective longitudinal case study was conducted. Participants were three men who had undergone, along with their wives, in vitro fertilization. The cause of their infertility was male or mixed. Fathers answered semi-structured interviews in three moments: a) third trimester of pregnancy; b) their babies’ third month of life; c) their babies’ first year of life. The unique pathways have been reported and analyzed based on the clinical report methodology. These three pathways were (re)constructed, with their unique challenges concerning elaboration and integration of fatherhood experience, as well as the researcher’s challenges. Loneliness could be felt in the reports of men who have experienced infertility and treatment. They said they cared more than were cared for. The importance of providing a space for listening to these men is emphasized, not only in a research situation, but also in the practice of mental health professionals who work in this context.

The aim of the thesis is to define content of various aspects of parenthood as they are currently perceived and treated in the legal order of the Czech Republic. The theme is reflected in the work with regard to its historical legal developments, including the reflection of the current Czech legislation. Mentioned is also legislation in terms of international law. It often represents the direction of Czech legislation. The main idea of the domestic legislation parenthood child's interest and the protection of basic human rights. The child is seen as a specific body of legal rules with all its peculiarities and increased need for legal protection with regard to their position in society. For contemporary society, which is child-centered, that is child-centered, are issues related to the rights of the child and his relevant status and position is important to be dealt with in relation to the child as possible and thoroughly as possible. The first part is devoted to the historical and legal aspects that are associated with parenthood issues. They discussed the basic concepts, such as a child, parenthood and family. Basic contents and meanings of these terms are viewed with regard to their interdisciplinary overlap. The core of the work, which is the most attention is the issue of motherhood. This...

Durante a injeção intracitoplasmática de espermatozoides (ICSI) seleciona-se um espermatozoide móvel e morfologicamente normal para injeção em ovócito maduro. Evidências recentes indicam que mesmo espermatozoides aparentemente normais podem ocultar defeitos em nível molecular. O principal objetivo deste trabalho foi a descrição de um novo método capaz de selecionar espermatozoides maduros a partir de amostras não processadas em procedimento de ICSI. Em um estudo comparativo e prospectivo testou-se uma gota estendida modificada. A \"gota estendida com mecanismo contracorrente\" - GEMC foi montada em uma placa de ICSI padrão a partir de seis gotas de meio de cultivo (10 ?L). O posicionamento e união precisa das gotas deram origem a dois reservatórios e um canal, resultando em um fluxo de líquido através do canal. A adição de uma solução de PVP (polivinilpirrolidona) gerou um gradiente de viscosidade no final do circuito. Amostras seminais foram obtidas de 40 pacientes inférteis. Cada amostra seminal foi dividida em 4 alíquotas: uma alíquota para o processamento por centrifugação em gradiente de densidade (CGD), uma alíquota para a GEMC utilizando amostras não processadas, uma alíquota para a GEMC utilizando amostras processadas e uma alíquota para controle. Nos grupos GEMC uma média de 200 espermatozoides foram consecutivamente coletados, sem seleção, no reservatório de captura utilizando-se uma micropipeta de injeção como no procedimento convencional de ICSI. A morfologia espermática foi avaliada e demonstrou melhora, comparando-se com os controles, em todos os tratamentos utilizados. A imaturidade da cromatina foi avaliada utilizando-se o teste do azul de anilina. Em relação à imaturidade, 100% dos homens obtiveram melhores resultados tanto após o preparo por CGD quanto utilizando o método GEMC. Isto se refletiu em uma redução das formas imaturas de 28.65 ± 8.97% no sêmen fresco para 17.29 ± 7.72% após processamento por CGD (P < 0.01). Uma redução ainda maior nas formas imaturas foi obtida após o método GEMC quando comparado com o processamento por CGD: 0.89 ± 1.31% (P < 0.01) utilizando-se sêmen fresco e 1.05 ± 1.63% (P < 0.01) utilizando-se amostras processadas. Um novo método unindo seleção e captura de espermatozoides em um mesmo procedimento de ICSI foi descrito e testado. O método GEMC seleciona espermatozoides de forma fácil e permite o uso direto de amostras não processadas em procedimentos de ICSI. Este método seleciona espermatozoides maduros com mais eficiência do que o processamento por CGD. Novos estudos são necessários para se analisar o impacto do método nas taxas de fertilização, desenvolvimento embrionário, gravidez, implantação e abortamento / During intracytoplasmic sperm injection (ICSI) a motile spermatozoon with normal morphology is visually selected for insemination of an oocyte. Recent evidence indicates that even though the sperm appears morphologically normal, a possibility of defects at the molecular level still exists. The main objective of this work was to describe a novel approach capable of selecting mature spermatozoa from unprocessed semen sample in a one-step ICSI procedure. A modified extended drop was tested in a prospective comparative study. The \"Gota Estendida com Mecanismo Contracorrente - GEMC\" (Positive Rheotaxis Extended Drop - PRED) was assembled on a standard ICSI dish and consisted of six culture medium droplets (10 ?L). The precise merging of the drops created two reservoirs and a channel therefore the fluid flew through the channel. The addition of a PVP solution created a viscosity gradient in the final sector of the circuit. Semen samples were taken from 40 subfertile men. Each semen sample was divided into four aliquots: one aliquot for density gradient centrifugation (DGC), one aliquot for GEMC using fresh semen, one aliquot for GEMC using processed semen and one aliquot for the control. In GEMC a mean of 200 spermatozoa were collected consecutively, without selection, from the outlet reservoir with an injecting pipette as for conventional ICSI procedure. Sperm morphology was assessed and resulted in improvement compared to controls in all treatments. Chromatin immaturity was assessed using aniline blue assay. Regarding to chromatin immaturity, 100% of men had better results after DGC preparation and GEMC approach. This was reflected in a mean reduction from 28.65 ± 8.97% uncondensed chromatin in the native ejaculates to 17.29 ± 7.72% in DGC processed semen (P < 0.01). An even greater reduction was achieved after GEMC approach showing a mean of 0.89 ± 1.31% uncondensed chromatin compared to DGC processed sample (P < 0.01). A novel one-step ICSI approach joining sperm selection and recovery was developed and tested. This GEMC approach can select sperm easily and permits the direct use of native semen in ICSI. This approach can select sperm with lower chromatin immaturity than DGC method. Further studies need to access its relation to fertilization, embryo development, pregnancy, implantation and miscarriage rates

Submitted by admin tede (tede@pucgoias.edu.br) on 2017-02-23T17:20:50Z No. of bitstreams: 1 KEILA CRISTINA FÉLIS.pdf: 1247728 bytes, checksum: 3c72be3ba99b9407d1bcf97679adc6b4 (MD5) / Made available in DSpace on 2017-02-23T17:20:50Z (GMT). No. of bitstreams: 1 KEILA CRISTINA FÉLIS.pdf: 1247728 bytes, checksum: 3c72be3ba99b9407d1bcf97679adc6b4 (MD5) Previous issue date: 2016-12-16 / This study aimed to understand the psychosocial effects of temporary infertility by stress in women. This is a descriptive cross-sectional study with qualitative and exploratory approach. The approach used in this study included conducting interviews with ten women who had proven diagnosis of temporary infertility by stress, the analysis of the interviews was based on the perspective of Grounded Theory. After transcription and subsequent analysis of the interviews, explanatory categories that emerged from the speeches of the interviewees were: No biological problems, undiagnosed; Impacts on social relationships; Impacts on the marital relationship; and the dream realized and future action. The results showed that the numbers of years of infertility treatment more positively also negatively influenced the lives of these women generating psychosocial stress. This study allowed the understanding of the psychosocial effects of temporary infertility by stress in women, which may contribute to work teams in developing strategies to support these, however there is the consistent data literature related to the subject, even in modern times whose infertility problem already set as a public health problem with increasing incidence in the world population. / O presente estudo objetivou compreender as repercussões psicossociais da infertilidade temporária por estresse em mulheres. Trata-se de um estudo transversal descritivo com abordagem qualitativa e exploratória. O procedimento metodológico utilizado nesse estudo compreendeu a realização de entrevistas com dez mulheres, que não apresentavam problema que impedisse a gestação mais tinham infertilidade temporária, a análise das entrevistas se baseou na perspectiva da Teoria Fundamentada nos Dados. Após a transcrição e posterior análise das entrevistas, as categorias explicativas que surgiram dos discursos das entrevistadas foram: sem problemas biológicos, sem diagnóstico; repercussões nas relações sociais; repercussões na relação conjugal; e o sonho realizado e providências futuras. Os resultados obtidos permitem concluir que os anos de tratamento de infertilidade influenciaram positivamente, mas também negativamente na vida dessas mulheres, gerando estresse psicossocial. Esse estudo permitiu a compreensão acerca das repercussões psicossociais da infertilidade temporária por estresse em mulheres, que pode contribuir para equipes de trabalho na elaboração de estratégias para o apoio a essas, entretanto não há na literatura dados consistentes relacionados ao tema, mesmo em tempos atuais cujo problema da infertilidade já se configura como um problema de saúde pública com crescente incidência na população mundial.

The relationship between the state and the people is a central theme in political theory. Discussions in this field have often centered on how a people can come to constitute a state. Less attention, however, has been directed toward the state’s role in constituting and recreating its people. This book examines the Swedish state’s role in forming the people by regulating the use of reproductive techniques: insemination, in vitro fertilization (IVF), and donations of sperm and eggs. The study focuses on how the issue of assisted reproduction was handled and problematized in Swedish policymaking between 1981 and 2005. What problem representations dominated the political debates and decision-making processes surrounding assisted reproduction? How was conflict expressed within the field of reproductive politics (i.e., what aspects caused conflict or political disagreement)? How did collective fantasies play into the political treatment of reproductive technologies? Using historical government and Riksdag material, four major policy debates have been analyzed, from the first legal regulation of assisted reproduction in Sweden in the 1980s up until the inclusion of lesbian couples as beneficiaries of gamete donation. Theoretically, the study is inspired by Ernesto Laclau and Chantal Mouffe’s political discourse theory, Lacanian psychoanalysis, and the “logics approach” developed by Jason Glynos and David Howarth. This combination of perspectives allows for a dual focus on both the form of political articulations and their affective force. Thus, the analysis tries to capture what was taken for granted within the discourse on reproduction (social logics), what arose as points of political conflict or contention (political logics), as well as the affective underpinnings of these social constructions and struggles (fantasmatic logics). The main result of the study is that even though the period saw a quite revolutionary development of new reproductive technologies, the reproduction policies under study took on much more moderate and hesitant character. Throughout the analyzed period there was a more or less consensual view that new reproductive technologies should only be allowed if they did not go against the “child’s best interest.” At the same time, there was significant political conflict over what constituted this interest. Moreover, the reforms that were made never fully embraced the radical implications of the new technologies. Rather, they clung on to previously established patterns of what a “real” family looked like. Thus, every move to allow a new technology or include another category of people as legitimate users of that technology was contingent upon the articulation of a discursive equivalence with previously naturalized methods of reproduction, ultimately taking the heterosexual, nuclear family as an implicit model. Finally, I argue that the production of “sense” in this terrain of radical undecidability was dependent on the mobilization of a series of collective fantasies about “natural life processes,” “nature’s imperfections,” “a humanist view of mankind,” “the stable, original nuclear family”, and so on.

Durante a injeção intracitoplasmática de espermatozoides (ICSI) seleciona-se um espermatozoide móvel e morfologicamente normal para injeção em ovócito maduro. Evidências recentes indicam que mesmo espermatozoides aparentemente normais podem ocultar defeitos em nível molecular. O principal objetivo deste trabalho foi a descrição de um novo método capaz de selecionar espermatozoides maduros a partir de amostras não processadas em procedimento de ICSI. Em um estudo comparativo e prospectivo testou-se uma gota estendida modificada. A \"gota estendida com mecanismo contracorrente\" - GEMC foi montada em uma placa de ICSI padrão a partir de seis gotas de meio de cultivo (10 ?L). O posicionamento e união precisa das gotas deram origem a dois reservatórios e um canal, resultando em um fluxo de líquido através do canal. A adição de uma solução de PVP (polivinilpirrolidona) gerou um gradiente de viscosidade no final do circuito. Amostras seminais foram obtidas de 40 pacientes inférteis. Cada amostra seminal foi dividida em 4 alíquotas: uma alíquota para o processamento por centrifugação em gradiente de densidade (CGD), uma alíquota para a GEMC utilizando amostras não processadas, uma alíquota para a GEMC utilizando amostras processadas e uma alíquota para controle. Nos grupos GEMC uma média de 200 espermatozoides foram consecutivamente coletados, sem seleção, no reservatório de captura utilizando-se uma micropipeta de injeção como no procedimento convencional de ICSI. A morfologia espermática foi avaliada e demonstrou melhora, comparando-se com os controles, em todos os tratamentos utilizados. A imaturidade da cromatina foi avaliada utilizando-se o teste do azul de anilina. Em relação à imaturidade, 100% dos homens obtiveram melhores resultados tanto após o preparo por CGD quanto utilizando o método GEMC. Isto se refletiu em uma redução das formas imaturas de 28.65 ± 8.97% no sêmen fresco para 17.29 ± 7.72% após processamento por CGD (P < 0.01). Uma redução ainda maior nas formas imaturas foi obtida após o método GEMC quando comparado com o processamento por CGD: 0.89 ± 1.31% (P < 0.01) utilizando-se sêmen fresco e 1.05 ± 1.63% (P < 0.01) utilizando-se amostras processadas. Um novo método unindo seleção e captura de espermatozoides em um mesmo procedimento de ICSI foi descrito e testado. O método GEMC seleciona espermatozoides de forma fácil e permite o uso direto de amostras não processadas em procedimentos de ICSI. Este método seleciona espermatozoides maduros com mais eficiência do que o processamento por CGD. Novos estudos são necessários para se analisar o impacto do método nas taxas de fertilização, desenvolvimento embrionário, gravidez, implantação e abortamento / During intracytoplasmic sperm injection (ICSI) a motile spermatozoon with normal morphology is visually selected for insemination of an oocyte. Recent evidence indicates that even though the sperm appears morphologically normal, a possibility of defects at the molecular level still exists. The main objective of this work was to describe a novel approach capable of selecting mature spermatozoa from unprocessed semen sample in a one-step ICSI procedure. A modified extended drop was tested in a prospective comparative study. The \"Gota Estendida com Mecanismo Contracorrente - GEMC\" (Positive Rheotaxis Extended Drop - PRED) was assembled on a standard ICSI dish and consisted of six culture medium droplets (10 ?L). The precise merging of the drops created two reservoirs and a channel therefore the fluid flew through the channel. The addition of a PVP solution created a viscosity gradient in the final sector of the circuit. Semen samples were taken from 40 subfertile men. Each semen sample was divided into four aliquots: one aliquot for density gradient centrifugation (DGC), one aliquot for GEMC using fresh semen, one aliquot for GEMC using processed semen and one aliquot for the control. In GEMC a mean of 200 spermatozoa were collected consecutively, without selection, from the outlet reservoir with an injecting pipette as for conventional ICSI procedure. Sperm morphology was assessed and resulted in improvement compared to controls in all treatments. Chromatin immaturity was assessed using aniline blue assay. Regarding to chromatin immaturity, 100% of men had better results after DGC preparation and GEMC approach. This was reflected in a mean reduction from 28.65 ± 8.97% uncondensed chromatin in the native ejaculates to 17.29 ± 7.72% in DGC processed semen (P < 0.01). An even greater reduction was achieved after GEMC approach showing a mean of 0.89 ± 1.31% uncondensed chromatin compared to DGC processed sample (P < 0.01). A novel one-step ICSI approach joining sperm selection and recovery was developed and tested. This GEMC approach can select sperm easily and permits the direct use of native semen in ICSI. This approach can select sperm with lower chromatin immaturity than DGC method. Further studies need to access its relation to fertilization, embryo development, pregnancy, implantation and miscarriage rates