[Studies on partial zona dissection in in vitro fertilization for severe male infertility]

The effects of partial zona dissection (PZD) were investigated in mouse in vitro fertilization (IVF) with an oligospermic model and then PZD was applied to patients with severe male infertility. Micromanipulated (PZD-treated) and zona-intact (control) mouse oocytes were inseminated with 1 x 10(4) (low sperm concentration) and 1 x 10(5), 1 x 10(6) (normal sperm concentration) motile sperm/ml. In mouse IVF with 1 x 10(4) sperm/ml, the fertilization rate in those PZD-treated were significantly higher than that in the control (21.3% vs 8.1%, p < 0.01). No polyspermy was observed. No significant difference in the rate of development to the blastocyst stage was seen between the PZD-treated and the control (71.0% vs 65.0%). The incorporation rate of 3H-leucine in embryos at the 2-cell and blastocyst stages also did not differ between the two groups of mice. Sixteen patients with severe male infertility who had failed to fertilize for the previous three consecutive IVF cycles were enrolled in the PZD protocol. The fertilization rate in PZD-treated cycles was significantly improved (19.6% in PZD-treated vs 0% in control cycles, p < 0.001). In ten patients who underwent replacement with PZD-treated embryos, one biochemical pregnancy occurred. The present study suggests that although PZD is useful for severe male infertility, further investigation is needed to evaluate PZD in assisted fertilization.