Utility of zona pellucida drilling in cases of severe semen alterations in man.
OBJECTIVE
To evaluate the utility of zona drilling for human severe sperm alterations in in vitro fertilization (IVF).


METHODS
A prospective randomized study was conducted according to random assignment of collected oocytes to a control or zona drilling procedure.


METHODS
Reproductive Biology Laboratory, University Hospital of Nantes, France.


METHODS
Twenty infertile couples with severe semen defects and previous IVF failure.


METHODS
Ultrasound-guided transvaginal follicular aspiration.


RESULTS
Fertilization rates were compared to assess the advantages of zona drilling: 93% (80/86) drilled oocytes survived and 18.75% (15) were fertilized, whereas only 3% (3/100) control oocytes were fertilized. The polyspermy rate for fertilized drilled oocytes was high (10/15; 66.6%). The normal fertilization rate after zona drilling remained very low (5/86; 5.8%) and was not statistically different from that of control oocytes (3/100; 3%). One implantation occurred after replacement of five drilled embryos in three patients but resulted in early miscarriage. Replacement of the single control embryo led to a progressive pregnancy and normal male birth.


CONCLUSIONS
This study indicates that zona drilling does not improve IVF results in cases of severe semen alterations.
Jean
M
M
Laboratoire de Biologie de la Reproduction, Centre Hospitalier Universitaire, Nantes, France.
Barriere
P
P
Sagot
P
P
L'Hermite
A
A
Lopes
P
P
D005260:Female; D005307:Fertilization in Vitro / Q000379:methods*; D006801:Humans; D008297:Male; D011247:Pregnancy; D011446:Prospective Studies; D013081:Sperm Motility; D013094:Spermatozoa / Q000002:abnormalities*; D015044:Zona Pellucida