title: Utility of zona pellucida drilling in cases of severe semen alterations in man.
abstract: 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.
authors.affiliation: Laboratoire de Biologie de la Reproduction, Centre Hospitalier Universitaire, Nantes, France.
authors.forename: M
authors.initials: M
authors.lastname: Jean
authors.forename: P
authors.initials: P
authors.lastname: Barriere
authors.forename: P
authors.initials: P
authors.lastname: Sagot
authors.forename: A
authors.initials: A
authors.lastname: L'Hermite
authors.forename: P
authors.initials: P
authors.lastname: Lopes
mesh_terms: 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