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Intracytoplasmic sperm injection for treating infertility associated with sperm autoimmunity
G N Clarke1, H Bourne, H W Baker
1Department of Pathology, Royal Women's Hospital, Carlton, Victoria, Australia.
Objective:
To determine whether intracytoplasmic sperm injection (ICSI) can be used to achieve normal fertilization, embryo cleavage, and pregnancies in cases of sperm autoimmunity.
Design:
A retrospective analysis of ICSI results in sperm antibody-positive and randomly selected antibody-negative groups.
Setting:
University- and hospital-based reproductive research laboratory and tertiary referral IVF program.
Patient(S):
Thirty-nine couples selected on the basis of a strongly positive result for sperm antibodies of immunoglobulin (Ig) G and/or IgA immunoglobulin class in the male partner and a control group of 140 antibody-negative couples.
Intervention(S):
Human menopausal gonadotropin, hCG and Lucrin (Abbott Australasia, Kurnell, NSW, Australia) were given by injection. Oocyte collection was by transvaginal ovarian puncture. Blood was collected for beta-hCG measurement.
Main Outcome Measure(S):
Normal fertilization, embryo cleavage, establishment of clinical pregnancy, and delivery.
Result(S):
There were no significant differences in fertilization rates (62% versus 58%) or clinical pregnancy rates (19% versus 12%) between sperm antibody-positive and sperm antibody-negative patient groups.
Conclusion:
Intracytoplasmic sperm injection is an effective treatment for patients with severe sperm autoimmunity.