title: Comparison of the efficacy of treating sperm with low hypoosmotic swelling test scores with chymotrypsin followed by intrauterine insemination vs in vitro fertilization with intracytoplasmic sperm injection.
abstract: OBJECTIVE
  To compare the efficacy of two treatments for sperm with low hypoosmotic swelling (HOS) test scores - intrauterine insemination (IUI) with sperm pretreated with the protein digestive enzyme chymotrypsin versus in vitro fertilization (IVF) with intracytoplasmic sperm injection (ICSI).
  
  
  METHODS
  The choice of patient therapy was optional. The pregnancy rates following two IUI cycles vs one IVF cycle with ICSI were then compared. The data were further stratified and compared according to the severity of the HOS score defect.
  
  
  RESULTS
  The more severe the HOS test defect the less likely for chymotrypsin therapy to work whereas the severity did not affect IVF with ICSI success. The use of IVF with ICSI was much more effective than IUI with chymotrypsin treatment.
  
  
  CONCLUSIONS
  Though IVF with ICSI is much more effective, IUI is much less expensive. Couples should be presented with these data and be allowed to make their own choice considering risks and expense versus efficacy and speed of success.
authors.affiliation: The University of Medicine and Dentistry of New Jersey, Robert Wood Johnson Medical School at Camden, NJ, USA.
authors.forename: A
authors.initials: A
authors.lastname: Bollendorf
authors.forename: D
authors.initials: D
authors.lastname: Check
authors.forename: J H
authors.initials: JH
authors.lastname: Check
authors.forename: W
authors.initials: W
authors.lastname: Hourani
authors.forename: K
authors.initials: K
authors.lastname: McMonagle
mesh_terms: D002918:Chymotrypsin / Q000494:pharmacology*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007315:Insemination, Artificial / Q000379:methods* / Q000592:standards; D008297:Male; D011247:Pregnancy; D012189:Retrospective Studies; D013094:Spermatozoa / Q000002:abnormalities* / Q000187:drug effects* / Q000378:metabolism
chemical_list: D002918:Chymotrypsin