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Micromanipulation at an infertility centre
A D Esterhuizen1, C A Groenewald, H W Lindeque
1Garden City Reproductive Biology Unit, Johannesburg.
Aim:
Human in vitro fertilisation (IVF) and gamete intrafallopian transfer have been used in the management of various forms of infertility. In cases of severe male-factor infertility, fertilisation can be a factor. In this study micromanipulation was used to increase fertilisation in such cases.
Methods:
Two micromanipulation techniques, subzonal sperm injection (SUZI) and partial zona dissection (PZD), were used to assist fertilisation in patients with abnormal semen parameters. Ten couples with severe oligo-, terato- and asthenozoospermia participated in the SUZI programme. Seventy-three oocytes were obtained from these 10 patients. PZD was used on day 1 oocytes in cases of male infertility as well as a rescue attempt on day 2 oocytes when fertilisation had failed after routine insemination.
Results:
The SUZI technique had a fertilisation rate of 37.7%. In this group, a biochemical pregnancy was achieved. Differences between the fertilisation rate of conventional IVF (33.3%) and PZD (56.3%) in cases of male infertility, were not statistically significant although a clinical difference could be detected. PZD was statistically effective in facilitating fertilisation (37.5% v. 8.3%) in couples where this procedure was introduced to reinseminate 24-hour-old unfertilised oocytes. Four patients received PZD reinseminated embryos. An average of 1.45 PZD embryos were replaced and 1 implantation pregnancy was confirmed.
Conclusion:
The micromanipulation results are encouraging and seemed to increase the efficiency of IVF in humans. Furthermore, our data support the conclusion that micromanipulation procedures can bring about pregnancies.
