title: Subzonal insertion of multiple sperm is a treatment for male factor infertility.
abstract: OBJECTIVE
  To determine whether subzonal insemination of multiple sperm is an effective treatment for male factor infertility.
  
  
  METHODS
  Subzonal insemination by micromanipulation of sperm and oocytes for male factor patients.
  
  
  METHODS
  Two hundred eight patients were selected on previous fertilization history and/or semen parameters. They could be assigned to one of three groups: group A had previous IVF failure, group B had a low fertilization rate with previous IVF, and group C had insufficient sperm for IVF.
  
  
  METHODS
  Oocytes were inseminated by subzonal insertion of multiple sperm.
  
  
  METHODS
  Fertilization and pregnancy rates.
  
  
  RESULTS
  There have been 208 patients treated through 332 treatment cycles. Of 2,789 oocytes inseminated, 784 oocytes were fertilized (28%) and 516 of these (66%) were monospermic. This represents normal fertilization in 207 cycles (62% of total patient cycles). These 207 cycles produced an average of 2.6 +/- 1.8 embryos. The resultant 487 embryos were either transferred or cryopreserved for future transfer. A total of 42 pregnancies (21% per ET) resulted from 200 ET procedures with 397 embryos. Miscarriages or elective terminations have occurred (11/42 pregnancies, 26% to date) and 21 deliveries have resulted in 26 babies. There are nine ongoing pregnancies. Three of the pregnancies have been from cryopreserved embryos. Group B patients had the highest fertilization rate (23%) but the lowest pregnancy rate (7%). No other significant relationships between patient group and outcome were found.
  
  
  CONCLUSIONS
  Subzonal insemination of multiple sperm is an effective treatment for some forms of male factor infertility.
authors.affiliation: Human Reproduction Unit, Royal North Shore Hospital, St. Leonards, New South Wales, Australia.
authors.forename: J
authors.initials: J
authors.lastname: Catt
authors.forename: U
authors.initials: U
authors.lastname: Krzyminska
authors.forename: L
authors.initials: L
authors.lastname: Tilia
authors.forename: E
authors.initials: E
authors.lastname: Csehi
authors.forename: J
authors.initials: J
authors.lastname: Ryan
authors.forename: I
authors.initials: I
authors.lastname: Pike
authors.forename: C
authors.initials: C
authors.lastname: O'Neill
mesh_terms: D004624:Embryo Transfer; D005260:Female; D005307:Fertilization in Vitro / Q000379:methods*; D006801:Humans; D007248:Infertility, Male / Q000628:therapy*; D008297:Male; D008846:Micromanipulation; D011247:Pregnancy; D011256:Pregnancy Outcome; D013084:Sperm-Ovum Interactions; D015044:Zona Pellucida / Q000502:physiology*