| dc.description.abstract |
Comparisons were made among techniques used to treat male factor infertility. Patients with semen quality below that recognized by World Health Organization criteria as normal had a better success rate when treated by gamete intrafallopian transfer than by in vitro fertilization (25% v. 7% pregnancy rate per patient). When < 2 x 10(6) motile sperm were recovered, the fertilization rate and embryo cleavage rate were higher for microdrop insemination than for conventional insemination. When 7000-370,000 motile sperm were recovered, microdrop insemination resulted in a higher fertilization rate (46%) and a higher incidence of pregnancies (23% of patients treated) than subzonal sperm microinjection (SUSM). However, for patients with 5000-50,000 motile sperm, the immediate transfer of SUSM oocytes to the Fallopian tube increased pregnancy rates for this technique to 24% of patients treated. Direct microinjection of epididymal sperm from azoospermic men into the cytoplasm of oocytes resulted in pronuclear formation in 27% of oocytes; in comparison, pronuclear formation occurred in 5% of SUSM oocytes. These data led to formulation of a logical treatment programme for male factor infertility. |
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