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Micromanipulation at an infertility centre
Abstract
Aim. Human in vitro fertilisation (IVF) and gamete intrafallopian transfer have been used in the management of various forms of infertility. In cases of severe male-factor infertility, fertilisation can be a factor. In this study micromanipulation was used to increase fertilisation in such cases.
Methods. Two micromanipulation techniques, subzonal sperm injection (SUZI) and partial zona dissection (PZD), were used to assist fertilisation in patients with abnorTl)al semen parameters. Ten couples with severe oligo-, teratoand asthenozoospermia participated in the SUZI programme. Seventy-three oocytes were obtained from these 10 patients. PZD was used on day 1 oocytes in cases of male infertility as well as a rescue attempt on day 2 oocytes when fertilisation had failed after routine insemination.
Results. The SUZI technique had a fertilisation rate of 37,7%. In this group, a biochemical pregnancy was achieved. Differences between the fertilisation rate of conventionallVF (33,3%) and PZD (56,3%) in cases of male infertility, were not statistically significant although a clinical difference could be detected. PZD was statistically effective in facilitating fertilisation (37,5% v. 8,3%) in couples where this procedure was introduced to reinseminate 24-hour-old unfertilised oocytes. Four patients received PZD reinseminated embryos. An average of 1,45 PZD embryos were replaced and 1 implantation pregnancy was confirmed.
Conclusion. The micromanipulation results are encouraging arid seemed to increase the efficiency of IVF in humans. Furthermore, our data support the conclusion that micromanipulation procedures can bring about pregnancies.
