Factors of importance for the establishment of a successful program of intracytoplasmic sperm injection treatment for male infertility.
OBJECTIVE
To establish an intracytoplasmic sperm injection treatment program for couples with male infertility and to determine those factors important for success.


METHODS
A retrospective analysis of 171 consecutive cycles of intracytoplasmic sperm injection concerning 145 infertile couples.


METHODS
Infertility clinic in a private hospital associated with a university hospital.


METHODS
Couples with infertility in the male partner whose sperm parameters were unacceptable for conventional IVF or in whom fertilization by conventional IVF failed repeatedly.


METHODS
One hundred seventy-one transvaginal oocyte retrievals were completed after superovulation with GnRH agonist and gonadotropins.


METHODS
The parameters evaluated included fertilization, cleavage, implantation, pregnancy, and spontaneous abortion in relation to patient indications and improved procedures.


RESULTS
After intracytoplasmic sperm injection, normal fertilization occurred in 45% of the oocytes (n = 1,499). Of 171 treatment cycles, 93% of the couples had fertilization and 86% had ET. Thirty-six pregnancies were achieved. During the period studied, the mean fertilization rate increased from 21.3% during the first 17 weeks to 67.8% during the last 13 weeks, and the pregnancy rate (PR) per started cycle increased from 12.8% to 31.3%.


CONCLUSIONS
Technical factors critical for achieving high rates of fertilization and pregnancy were the use of standardized intracytoplasmic sperm injection pipettes, the immobilization of sperm before injection, and the aspiration of a minimal amount of ooplasm before reinjection with the sperm. Intracytoplasmic sperm injection appears to be superior to other micromanipulation methods for alleviating male infertility.
Svalander
P
P
Fertility Center Scandinavia, Carlanderska Hospital, Göteborg, Sweden.
Forsberg
A S
AS
Jakobsson
A H
AH
Wikland
M
M
D000328:Adult; D001723:Birth Rate; D003593:Cytoplasm; D005260:Female; D005307:Fertilization in Vitro / Q000379:methods*; D006801:Humans; D007248:Infertility, Male / Q000628:therapy*; D008297:Male; D008845:Microinjections; D008875:Middle Aged; D011247:Pregnancy; D012189:Retrospective Studies; D013076:Sperm Count; D013081:Sperm Motility; D013094:Spermatozoa