Successful pregnancy requires good quality of both gametes. In males, three common conditions including azoospermia, cryptozoospermia and necrospermia robustly deteriorated sperm quality and were main causes of male infertility. The study analyzed their influences in the developmental outcomes and treatments by comparing to the donor sperm with fertile ability.
71 couples (72 cycles in total) with male factor infertility were treated with ICSI (intracytoplasmic sperm injection) and IVF (in vitro fertilization) using husband’s sperm and donor semen in the same cycle, due to inadequate sperm in husband’s semen to fertilize all available oocytes. All males of average 31.42 years old had severely poor quality of sperms that were categorized into three groups: Group A (azoospermia, 27 cycles), Group B (cryptozoospermia, 34 cycles) and Group C (necrospermia, 11 cycles). The females of average 28.47 years old had no infertility factors. The fertilization was achieved by ICSI with her husband sperm (HS) and also by IVF/ICSI with donor sperm (as a control). Embryo transfer (ET) was preferably performed with good quality embryos from HS (57 in total) and 7 with donor sperm-derived embryos. The mean number of oocytes retrieved in each cycle of ICSI/IVF was 17.5. By comparing HS with the control, the fertilization rates were 65.4% vs. 83.2% (p<0.05) for Group A, 68.8% vs. 75.5% (p>0.05) for Group B, and 65% vs. 85% (p<0.05) for Group C. The overall rates of fertilization, cleavage, good-quality embryos, clinical pregnancy and birth in all three groups were 66.8% vs. 79.9% (p<0.05), 95.6% vs. 97.7% (p>0.05), 50.2% vs. 49.7% (p>0.05), 36.8% vs. 42.9% (p>0.05) and 35.1% vs. 28.6% (p>0.05), respectively.
Our results demonstrated that poor sperm quality with azoospermia, cryptozoospermia and necrospermia had negative impact on fertilization process. This was effectively overcome by ICSI as a consequence of the embryos developed from the sperms with these three severe conditions gave rise to the similar rates of the cleavage, good-quality embryo and clinical pregnancy to the control. (321 words)