Subzonal insemination: a prospective randomized study in patients with abnormal sperm morphology

Area of Science:

• Reproductive Medicine
• Assisted Reproductive Technologies
• Male Infertility

Background:

• Male subfertility is a significant factor in couples' inability to conceive.
• Conventional in vitro fertilization (IVF) methods may be less effective in cases of severe male factor infertility.
• Subzonal insemination (SUZI) is an advanced technique aimed at overcoming fertilization challenges.

Purpose of the Study:

• To prospectively evaluate the efficacy of subzonal insemination (SUZI) compared to conventional insemination in patients with male subfertility.
• To determine the impact of sperm morphology on SUZI outcomes.
• To assess key fertility parameters including fertilization, cleavage, implantation, and pregnancy rates.

Main Methods:

• A prospective randomized study was conducted involving 48 patients undergoing IVF for male subfertility.
• Sibling oocytes were subjected to both normal insemination and SUZI.
• Patients were stratified into three groups based on strict criteria for sperm morphology (10-14%, 5-10%, and 0-5%).

Main Results:

• SUZI demonstrated a significantly higher fertilization rate (32%) compared to normal insemination (7%).
• The improvement in fertilization rates with SUZI was particularly pronounced in groups with lower sperm morphology (35% and 33% vs. 11% and 4%).
• Cleavage, implantation, and pregnancy rates were also evaluated for comparison.

Conclusions:

• Subzonal insemination (SUZI) is an effective method for enhancing fertility outcomes in men with subfertility.
• The benefits of SUZI are most evident when sperm morphology, assessed by strict criteria, is below 10%.