Very low sperm count affects the result of intracytoplasmic sperm injection.
OBJECTIVE
The aim was to examine the influence of extremely low sperm count on intracytoplasmic sperm injection (ICSI) outcome.


METHODS
Over 1000 consecutive unselected ICSI cycles were divided into four groups according to sperm concentration of their patients: A, cryptozoospermia, 107 patients; B, sperm concentration of < or = 1 x 10(4), 146 patients; C, sperm count of 1 x 10(4)-1 x 10(5), 135 patients; and concentration of > 1 x 10(5) and < 10 x 10(6)/ml (control group), 688 patients.


RESULTS
A significant decrease in pregnancy rate was noticed in the cryptozoospermic group in comparison to the control group (20% vs. 31%). Fertilization rate in group A was significantly lower in comparison to all other groups, respectively (46% vs. 52%, 54%, 61%). Embryo quality was inferior in group A in comparison to the control group. A higher yet not statistically significant abortion rate was observed in the cryptozoospermic group (as well as in group C) (30%, 27%) compared to the control group (15%).


CONCLUSIONS
It seems that an extremely low sperm count has a negative effect on the outcome of ICSI. Nevertheless patients with cryptozoospermia should not be offered ICSI treatment with the ejaculated sperm before karyotype is established.
Strassburger
D
D
IVF and Infertility Unit, Assaf Harofeh Medical Center, Zerifin, Israel.
Friedler
S
S
Raziel
A
A
Schachter
M
M
Kasterstein
E
E
Ron-el
R
R
D000328:Adult; D005260:Female; D005307:Fertilization in Vitro / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008845:Microinjections; D009845:Oligospermia / Q000150:complications*; D011247:Pregnancy; D018873:Pregnancy Rate; D013048:Specimen Handling / Q000379:methods; D013076:Sperm Count; D020554:Sperm Injections, Intracytoplasmic / Q000379:methods*; D013081:Sperm Motility / Q000502:physiology; D013084:Sperm-Ovum Interactions; D013094:Spermatozoa / Q000166:cytology