Fertilization after standard in vitro fertilization versus intracytoplasmic sperm injection in subfertile males using sibling oocytes.
OBJECTIVE
To compare conventional IVF with ICSI in the subfertile male population using sibling oocytes. Results from males with isolated severe teratozoospermia also are analyzed.


METHODS
Prospective experimental study.


METHODS
University based IVF clinic.


METHODS
Group A: 18 patients with one or more abnormalities in count, motility, or morphology. Group B: 20 patients with isolated severe teratozoospermia (< or = 4% Kruger Strict Criteria).


METHODS
Ovulation induction, random allocation of sibling oocytes, and IVF or ICSI.


METHODS
Fertilization rates (fertilization per cycle, fertilization per oocytes, and fertilization per couple) and embryo quality.


RESULTS
In group A, fertilization occurred in 13 of 18 (72%) of IVF cycles and 17 of 18 (94%) of ICSI cycles. Overall, 69 of 120 (58%) oocytes fertilized after IVF, whereas 80 of 131 (61%) fertilized after ICSI. The mean (+/-SEM) percent of oocytes fertilized per couple was 44.6%+/-9.0% with IVF and 62.7%+/-5.6% with ICSI (not statistically significant). In group B, fertilization occurred in 18 of 20 (90%) cycles after IVF and 20 of 20 (100%) cycles with ICSI. Overall, 54 of 113 (48%) of the oocytes fertilized after IVF, whereas 82 of 124 (66%) fertilized with ICSI. The mean (+/-SEM) percent of oocytes fertilized per couple was 50.9%+/-7.1 % with IVF and 66.6%+/-4.7% with ICSI. No statistically significant difference in embryo quality after IVF versus ICSI was demonstrated.


CONCLUSIONS
With severe teratozoospermia, ICSI results in higher fertilization rates than conventional IVF, without altering embryo quality. In our subfertile male population, there is a trend toward improved fertilization with ICSI, with less failed fertilization.
Pisarska
M D
MD
Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, Texas 77030, USA.
Casson
P R
PR
Cisneros
P L
PL
Lamb
D J
DJ
Lipshultz
L I
LI
Buster
J E
JE
Carson
S A
SA
D004624:Embryo Transfer; D004622:Embryo, Mammalian / Q000502:physiology; D005260:Female; D005307:Fertilization in Vitro / Q000379:methods*; D006801:Humans; D007248:Infertility, Male; D008297:Male; D008845:Microinjections; D010062:Ovulation Induction; D011247:Pregnancy; D011446:Prospective Studies; D013094:Spermatozoa / Q000002:abnormalities