title: National study of factors influencing assisted reproductive technology outcomes with male factor infertility.
abstract: OBJECTIVE
  To evaluate the outcomes of assisted reproductive technology (ART) cycles for male factor infertility, and method of sperm collection.
  
  
  METHODS
  Historic cohort study.
  
  
  METHODS
  Clinic-based data.
  
  
  METHODS
  Cycles from the Society for Assisted Reproductive Technology Clinic Outcomes Reporting System database for 2004 to 2008 were limited to three groups: non-intracytoplasmic sperm injection (ICSI) and ICSI cycles for tubal ligation only; non-ICSI and ICSI cycles for male factor infertility only; and all cycles (regardless of infertility diagnosis) using ICSI only.
  
  
  METHODS
  Multivariate logistic regression was used to model the adjusted odds ratio (AOR) of clinical intrauterine gestation (CIG) and live birth (LB) rates for tubal ligation versus male factor infertility only; ICSI versus non-ICSI for male factor infertility only; and ICSI outcomes based on method of sperm collection.
  
  
  RESULTS
  Models for male factor infertility only versus tubal ligation only ICSI cycles had lower CIG (AOR 0.92) but not LB (AOR 0.87). No difference was seen for non-ICSI cycles. Within male factor infertility only cycles, ICSI had a worse outcome than non-ICSI for CIG (AOR 0.93) but not for LB (AOR 0.94). For all ICSI cycles with no male factor infertility and ejaculated sperm as the reference group, models showed better rates of CIG with male factor infertility ejaculated sperm (AOR 1.07) and with male factor infertility aspirated sperm (AOR 1.09). The LB rate was higher with male factor infertility ejaculated sperm only (AOR 1.04).
  
  
  CONCLUSIONS
  The ICSI and sperm source influence CIG and LB rates in male factor infertility cases.
authors: Department of Urology, University of Kansas Medical Center, Kansas City, Kansas 66160, USA. anangia@kumc.edu
authors: Ajay K
authors: AK
authors: Nangia
authors: Barbara
authors: B
authors: Luke
authors: James F
authors: JF
authors: Smith
authors: Winifred
authors: W
authors: Mak
authors: Judy E
authors: JE
authors: Stern
mesh_terms: D000328:Adult; D016208:Databases, Factual / Q000706:statistics & numerical data; D004542:Ejaculation; D004558:Electric Stimulation; D005260:Female; D006801:Humans; D007248:Infertility, Male / Q000453:epidemiology* / Q000628:therapy*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011247:Pregnancy; D018873:Pregnancy Rate; D015995:Prevalence; D020554:Sperm Injections, Intracytoplasmic / Q000706:statistics & numerical data*; D013094:Spermatozoa / Q000166:cytology*; D013246:Sterilization, Tubal / Q000706:statistics & numerical data; D013396:Suction; D014481:United States / Q000453:epidemiology