Could in vitro fertilization with a modified sperm preparation technique be an option to micromanipulations?
OBJECTIVE
This study evaluated the efficiency of in vitro fertilization with a modified sperm preparation technique for male infertility, to avoid systematic recourse to ICSI.


METHODS
The sperm function stimulants pentoxifylline, 2-deoxyadenosine, and follicular fluid were used during the sperm preparation of IVF trials for two groups of patients: couples with long-standing infertility and previous IVF failures and couples with male-factor infertility scheduled for their first treatment.


RESULTS
Forty-nine attempts were performed in the first group. The overall fertilization rate (percentage of zygotes with two pronuclei 18 hr after sperm insemination) was 30% and the clinical pregnancy rate per transfer was 33%. For the second group, 30 attempts were performed. The fertilization rate was 29.6% and the clinical pregnancy rate was 62.5% per transfer. The total number of recovered motile sperm appears to be a significant parameter: a cutoff value of 0.25 million motile sperm recovered after capacitation treatment has a good prognostic value for choosing between IVF with sperm enhancers and ICSI.


CONCLUSIONS
The described modified IVF could constitute an alternative to the systematic use of ICSI.
Wittemer
C
C
Départment de Procréation Médicalement Assistée, Centre Médico-Chirurgical et Obstétrical, Schiltigheim, France.
Ohl
J
J
Bettahar-Lebugle
K
K
Moreau
L
L
Dellenbach
P
P
D000328:Adult; D003839:Deoxyadenosines / Q000494:pharmacology*; D004624:Embryo Transfer; D005260:Female; D005307:Fertilization in Vitro / Q000379:methods*; D006801:Humans; D007248:Infertility, Male; D008297:Male; D010431:Pentoxifylline / Q000494:pharmacology*; D011247:Pregnancy; D011256:Pregnancy Outcome; D013076:Sperm Count / Q000187:drug effects; D013081:Sperm Motility / Q000187:drug effects; D013094:Spermatozoa / Q000187:drug effects* / Q000502:physiology
D003839:Deoxyadenosines; D010431:Pentoxifylline