title: Randomized trial of partial zona dissection for male infertility.
abstract: OBJECTIVE
  To compare IVF rates using partial zona dissection versus zona intact insemination in couples with male infertility. To analyze pregnancy rates relative to sperm characteristics, fertilization rates, and treatment.
  
  
  METHODS
  Randomized prospective comparison of fertilization in sibling oocytes. Transfer of the three best quality embryos from one or both treatments.
  
  
  METHODS
  Department of Gynaecology and Reproductive Medicine, University Hospital, London, Ontario, Canada.
  
  
  METHODS
  Thirty-two couples undergoing IVF with a principal diagnosis of male infertility.
  
  
  METHODS
  Treatment with partial zona dissection.
  
  
  METHODS
  Fertilization and pregnancy.
  
  
  RESULTS
  Fertilization rates were 26% and 9% after partial zona dissection and IVF, respectively. Polyspermy was < 1% in each treatment. There were five singleton pregnancies in 29 completed cycles, three in cycles with fertilization only by partial zona dissection and two in cycles with both partial zona dissection and IVF fertilization. There were no pregnancies after fertilization by IVF only. Stepwise logistic regression analysis indicated that pregnancy was related to partial zona dissection, initial sperm concentration, and total acrosin activity.
  
  
  CONCLUSIONS
  Partial zona dissection was associated with minimal polyspermic fertilization and higher normal fertilization rates than sibling oocytes treated by modified IVF. Pregnancy occurred only after transfer of embryos from partial zona dissection or combined partial zona dissection and IVF.
authors.affiliation: University of Western Ontario, London, Ontario, Canada.
authors.forename: I S
authors.initials: IS
authors.lastname: Tummon
authors.forename: R E
authors.initials: RE
authors.lastname: Gore-Langton
authors.forename: S A
authors.initials: SA
authors.lastname: Daniel
authors.forename: P M
authors.initials: PM
authors.lastname: Squires
authors.forename: J J
authors.initials: JJ
authors.lastname: Koval
authors.forename: M B
authors.initials: MB
authors.lastname: Alsalili
authors.forename: J S
authors.initials: JS
authors.lastname: Martin
authors.forename: B R
authors.initials: BR
authors.lastname: Kaplan
authors.forename: J A
authors.initials: JA
authors.lastname: Nisker
authors.forename: A A
authors.initials: AA
authors.lastname: Yuzpe
mesh_terms: D000328:Adult; D004210:Dissection; D005260:Female; D005306:Fertilization; D005307:Fertilization in Vitro / Q000379:methods*; D006801:Humans; D007248:Infertility, Male / Q000628:therapy*; D008297:Male; D008846:Micromanipulation; D011247:Pregnancy; D011446:Prospective Studies; D013076:Sperm Count; D013081:Sperm Motility; D015044:Zona Pellucida