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Two years of assisted fertilization by partial zona dissection in male factor infertility patients
G Calderón1, A Veiga, J Penella
1Department of Obstetrics and Gynecology, Institut Universitari Dexeus, Barcelona, Spain.
Objective:
To assess partial zona dissection in our routine IVF-ET program over a 2-year period.
Design:
Partial zona dissection before insemination on the day of oocyte collection or 24 hours after unsuccessful conventional IVF. In a subgroup of patients, oocytes were randomized to either partial zona dissection before insemination or IVF.
Setting:
University infertility clinic.
Patients:
Couples who suffered principally from male factor infertility or who had failed fertilization previously.
Interventions:
Micromanipulation of oocytes with partial zona dissection.
Main Outcome Measures:
Comparison of fertilization rate, embryo morphology, and implantation rate between partial zona dissection inseminated oocytes and conventional IVF inseminated oocytes (controls).
Results:
Five pregnancies were established in 199 patients. The incidence of polyspermy was significantly higher in the partial zona dissection group than in conventional IVF (4.8% versus 1.3%). There were no significant differences in the remaining parameters. The fertilization rate of partial zona dissection and reinsemination was significantly higher than conventional IVF insemination (13.6% versus 4.5%) but similar to the rate obtained when partial zona dissection was applied before insemination (13.6% versus 15.7%).
Conclusions:
Oocytes treated by partial zona dissection did not exhibit a greater fertilization rate than conventional IVF inseminated oocytes. Partial zona dissection may not be a useful technique for treating severe male factor infertility.