The outcome of ART in males with impaired spermatogenesis

Abstract

AIMS:This study was conducted to evaluate the outcomes of assisted reproductive technology (ART) procedures, viz., intrauterine insemination (IUI), in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI) in males with impaired spermatogenesis.SETTINGS AND DESIGN:The subjects of the study were infertile couples who were undergoing ART treatment due to male factor indications. The project was designed to correlate the outcome of the ART treatment and its efficacy in different study groups.METHODS:Males were grouped as: 1. oligozoospermia (n = 153), 2. asthenoteratozoospermia (n = 158), 3. obstructive azoospermia (n = 110) and 4. nonobstructive azoospermia (n = 58). Patients from groups 1 and 2 were considered for IUI, IVF and ICSI. Those from group 3 were considered for IVF and ICSI and the 4th group underwent only ICSI treatment.RESULTS:Oligozoospermia showed lower pregnancy rates with IUI than with both IVF and ICSI. An average minimum native and postharvest count was obtained to get an acceptable IUI outcome. Asthenoteratozoospermia had the lowest pregnancy rate with IUI as compared to IVF, whereas ICSI showed significantly higher pregnancy rates in this group. Obstructive azoospermia showed significant improvement with ICSI over IVF. In nonobstructive azoospermia, ICSI resulted in a 27.58% pregnancy rate.CONCLUSION:The IUI outcome was impressive though less effective whereas there was no difference between the IVF and ICSI outcomes in oligozoospermia. In asthenoteratozoospermia, ICSI showed a significant advantage over IUI and IVF, with IUI resulting in poor outcome in this group. In obstructive azoospermia, ICSI had a distinct advantage over IVF whereas in nonobstructive azoospermia, ICSI, the only option, was found to be effective and helpful in achieving an acceptable pregnancy rate.

Testicular sperm from patients with obstructive and nonobstructive azoospermia: aneuploidy risk and reproductive prognosis using testicular sperm from fertile donors as control samples

“…None of our 11 OA patients with vasectomy had increased sperm chromosomal abnormalities, consistent with earlier results of infertile OA patients and fertile men undergoing vasectomy reversal (18,19). Moreover, good ICSI pregnancy and implantation rates were observed in our OA patients, similar to those described in the literature (3,5), indicating that this level of sperm aneuploidy would not affect reproductive outcomes.…”

“…However, questions surround the success rates of the ICSI technique in obstructive (OA) and nonobstructive (NOA) azoospermic males. Some authors describe similar and high fertilization and pregnancy rates (3)(4)(5), whereas others report lower ICSI outcomes in NOA than in OA patients (6,7).…”

Biomarkers of human oocyte developmental competence expressed in cumulus cells before ICSI: a preliminary study

“…The selection of patients for ICSI treatment was based on the diagnosis of male factor infertility due to reduced sperm quality (mainly morphological abnormalities). ICSI was the recommended and the most efficient approach in this case to prevent male factor effect [33]. In a collaborative approach, all patients underwent an extensive andrological, gynaecological and cytogenetic examination prior to ICSI to avoid any other bias.…”

The role of varicocele sclerotherapy in men with severe oligo-astheno-teratozoospermia

“…In these patients, ICSI showed a significantly better pregnancy rate than IUI and IVF. 40,41 Mangoli et al 41 found that ICSI showed a significantly higher pregnancy rate (29%) over IVF (13.2%) for men with OAT, whereas IVF showed a significant advantage over IUI (pregnancy rate of 8%).…”