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Micromanipulation at an infertility centre
A D Esterhuizen1, C A Groenewald, H W Lindeque
1Garden City Reproductive Biology Unit, Johannesburg.
Summary
Micromanipulation techniques like SUZI and PZD show promise in improving human in vitro fertilization (IVF) success rates, particularly for severe male-factor infertility. These methods can assist fertilization and lead to pregnancies when conventional IVF fails.
Area of Science:
- Reproductive Medicine
- Assisted Reproductive Technologies
- Human Embryology
Background:
- In vitro fertilization (IVF) and gamete intrafallopian transfer are established treatments for infertility.
- Severe male-factor infertility, characterized by low sperm count, motility, or abnormal morphology, presents unique fertilization challenges.
- Micromanipulation techniques offer potential solutions for overcoming fertilization barriers in assisted reproduction.
Purpose of the Study:
- To evaluate the efficacy of micromanipulation techniques in improving fertilization rates in human IVF.
- To assess the success of subzonal sperm injection (SUZI) and partial zona dissection (PZD) in cases of severe male-factor infertility.
- To determine if micromanipulation can lead to successful pregnancies in patients with previous IVF fertilization failures.
Main Methods:
- Two micromanipulation techniques, SUZI and PZD, were employed to assist fertilization.
- SUZI was performed on oocytes from couples with severe oligo-, terato-, and asthenozoospermia.
- PZD was used on day 1 oocytes for male infertility and as a rescue strategy on day 2 for unfertilized oocytes after conventional insemination.
Main Results:
- The SUZI technique resulted in a 37.7% fertilization rate, with one biochemical pregnancy achieved.
- Partial zona dissection (PZD) showed a fertilization rate of 56.3% in male infertility cases, compared to 33.3% with conventional IVF.
- PZD significantly improved fertilization rates (37.5% vs. 8.3%) when used to reinseminate unfertilized oocytes, leading to one confirmed implantation pregnancy from four PZD-assisted embryo transfers.
Conclusions:
- Micromanipulation techniques, including SUZI and PZD, appear to enhance the efficiency of human IVF.
- These micromanipulation procedures are capable of achieving pregnancies, offering a viable option for challenging infertility cases.
- The study provides encouraging data supporting the use of micromanipulation to overcome fertilization issues in assisted reproductive technology.