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Could in vitro fertilization with a modified sperm preparation technique be an option to micromanipulations?
C Wittemer1, J Ohl, K Bettahar-Lebugle
1Départment de Procréation Médicalement Assistée, Centre Médico-Chirurgical et Obstétrical, Schiltigheim, France.
Purpose:
This study evaluated the efficiency of in vitro fertilization with a modified sperm preparation technique for male infertility, to avoid systematic recourse to ICSI.
Methods:
The sperm function stimulants pentoxifylline, 2-deoxyadenosine, and follicular fluid were used during the sperm preparation of IVF trials for two groups of patients: couples with long-standing infertility and previous IVF failures and couples with male-factor infertility scheduled for their first treatment.
Results:
Forty-nine attempts were performed in the first group. The overall fertilization rate (percentage of zygotes with two pronuclei 18 hr after sperm insemination) was 30% and the clinical pregnancy rate per transfer was 33%. For the second group, 30 attempts were performed. The fertilization rate was 29.6% and the clinical pregnancy rate was 62.5% per transfer. The total number of recovered motile sperm appears to be a significant parameter: a cutoff value of 0.25 million motile sperm recovered after capacitation treatment has a good prognostic value for choosing between IVF with sperm enhancers and ICSI.
Conclusions:
The described modified IVF could constitute an alternative to the systematic use of ICSI.