Evaluation of 225 patients undergoing subzonal insemination for the procurement of fertilization in vitro.
OBJECTIVE
To evaluate subzonal insemination for the procurement of fertilization in infertile males.


METHODS
The spermatozoa of infertile males was used, where possible, for in vitro fertilization (IVF) and subzonal insemination with the same cohort of oocytes obtained from their partner.


METHODS
An individual unit in a general hospital, Clinical Nomentana, Rome, Italy.


METHODS
Males who had repeatedly failed to achieve conception in vitro by IVF or in whom seminal parameters were unacceptable for IVF were treated.


METHODS
Two hundred twenty-five transvaginal oocyte retrievals were performed.


METHODS
The incidence of fertilization, cleavage, and pregnancy was evaluated in relation to the numbers of spermatozoa injected and the individual spermatozoa parameters.


RESULTS
Fertilization occurred in 39% of patients and 16% of eggs, and 12 clinical pregnancies were established. Fertilization increased with increasing numbers of spermatozoa injected. Fertilization with subzonal insemination was significantly greater (39%) than after in vitro insemination (6%) (P less than 0.0001).


CONCLUSIONS
Subzonal insemination improved the incidence of fertilization in this series of patients, and a new classification of spermatozoa based on total motile count aided prognosis for fertilization.
Fishel
S
S
University Hospital, Queen's Medical Centre, Nottingham, United Kingdom.
Timson
J
J
Lisi
F
F
Rinaldi
L
L
D000328:Adult; D003692:Delayed-Action Preparations; D005260:Female; D005307:Fertilization in Vitro; D007987:Gonadotropin-Releasing Hormone / Q000031:analogs & derivatives / Q000627:therapeutic use; D006801:Humans; D007317:Insemination, Artificial, Homologous / Q000379:methods*; D008297:Male; D009845:Oligospermia / Q000503:physiopathology*; D009865:Oocytes / Q000166:cytology / Q000502:physiology*; D011247:Pregnancy; D013076:Sperm Count; D013081:Sperm Motility; D013094:Spermatozoa / Q000502:physiology*; D017329:Triptorelin Pamoate / Q000031:analogs & derivatives*
D003692:Delayed-Action Preparations; D017329:Triptorelin Pamoate; D007987:Gonadotropin-Releasing Hormone; C019176:Tryptal