New developments in the treatment of male sub-fertility by means of assisted fecundation techniques.
In the second bimester of 1990 we have performed IVF/ET in a group of patients who had previously been excluded from the IVF/ET programme for severe dyspermia and negative Pellet Swim-up Test (PST). This group consisted of 101 cases of whom 38 underwent semen treatment with Centrifugation on a Discontinuous Percoll Gradient (CDPG) and 63 with Pellet Swim-up (PS); the control group was made up of 31 normospermic patients where the semen was treated by PS. Furthermore, in the same period, we performed Tubal Embryo Stage Transfer (TEST) on 5 normospermic and on 2 dyspermic cases, as well as Zygote Intra-Fallopian Tubal Transfer (ZIFT) on 2 normospermic patients. In all these cases the sperm was always treated with PS. We obtained disappointing IVF/ET results in the dyspermic patients with negative PST where the semen was treated with PS, with only one pregnancy (pregnancy rate 1.6% per patient). Unexpected results were obtained in cases of severe dyspermia where the semen was treated with CDPG (5 pregnancies out of 38 cases; pregnancy rate 13.1% per patient) (chi square = 7.03, p 0.01). We obtained remarkable Test results: 4 pregnancies out of 5 cases of unexplained infertility and one pregnancy out of 2 cases of dyspermia. Moreover we obtained one pregnancy in the two ZIFT's performed. The use of CDPG, possibly associated with Test, will open new horizons in the treatment of dyspermic patients by means of assisted fecundation techniques.
Cimino
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C
Istituto Materno-Infantile, Università di Palermo.
Cittadini
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E
Gattuccio
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F
D006801:Humans; D007248:Infertility, Male / Q000628:therapy*; D008297:Male; D012099:Reproductive Techniques