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Evidence that oligoasthenozoospermia may be an etiologic factor for spontaneous abortion after in vitro
D Kiefer1, J H Check, D Katsoff
1Department of Obstetrics and Gynecology, University of Medicine and Dentistry of New Jersey (UMDNJ)-Robert Wood Johnson Medical School at Camden, USA.
Objective:
To evaluate whether oligoasthenozoospermia may lead to a higher spontaneous abortion (SAB) rate once a pregnancy is established by IVF-ET.
Design:
Retrospective clinical observational study.
Setting:
University-based IVF program.
Patient(S):
Three hundred sixty-four couples with normal semen parameters who underwent IVF-ET with conventional sperm incubation; 70 couples with oligoasthenozoospermia but without marked abnormal sperm morphology (< 4% normal forms using strict criteria) who underwent ET after IVF with conventional sperm incubation; and 20 couples with oligoasthenozoospermia but without abnormal sperm morphology who underwent ET after IVF with intracytoplasmic sperm injection (ICSI).
Main Outcome Measure(S):
Implantation rate, clinical pregnancy rate, SAB rate, and delivery rate after IVF-ET.
Result(S):
Despite similar pregnancy and implantation rates per ET, as a result of a higher SAB rate (40.0% versus 11.7%), the delivery rates were lower in the female partners of men with oligoasthenozoospermia. Similar patients who used ICSI had a 0% SAB rate.
Conclusion(S):
Oligoasthenozoospermia should be considered a possible risk factor for SAB in IVF achieved pregnancies. Further studies are needed to determine whether ICSI reduces the risk of SAB associated with oligoasthenozoospermia.