2014년 미국불임학회(ASRM) P-822 Will Conventional IVF without ICSI be sufficient for mild oligospermia? (경미한 희소정자증을 보일 때 미세수정을 통한 시험관 시술이 반드시 필요한가?)

Y.Y Kim1, I.H. Park1, K.H. Lee1, H.G. Sun1, S.K. Kim1, J.H. Lee1, S.J. Kwak1
1 Infertility Lab., mamapapa & Baby Obstetrics and Gynecology Clinic, ULSAN, Republic of Korea

OBJECTIVE

Oligospermia is a leading cause of infertility. While severe oligospermia requires ICSI, it is not clear whether mild oligospermia needs ICSI or conventional IVF suffices. The purpose is to evaluate whether there are differences in fertilization rate and pregnancy rate when subnormal sperm and normal sperm are treated with conventional IVF without ICSI.

MATERIALS AND METHODS

All fresh, non-donor in conventional IVF without ICSI cycles performed from January 2012 to December 2013 (n=838) were included in this study. The patients were divided into two groups:
Study group (A group): A total of 115 patients underwent subnormal sperm count (≥5 and <20 × 106/mL).
Control group (B group): A total of 723 patients underwent normal sperm count ≥20 × 106/mL).
Both groups became normal count after sperm treatment.

RESULTS

Patient characteristics were similar between two groups. In each group, age (A group: 35.3±3.6; B group: 35.7±4.0 P=0.73), basal FSH (7.4±2.6; 7.3±3.7mIU/ml P=0.76), duration of rFSH (9.0±2.3; 9.1±3.2day P=0.81), and endometrial thickness (10.1±2.0; 10.1±2.1mm P=0.41) did not show significant differences. There were no significant differences between two groups in the number of MII oocytes (10.8±6.6; 10.1±6.2 P=0.93), fertilization rate (85.2%; 88.8% p=0.64), pregnancy rate (57.4%; 54.8% P=0.85), and ongoing pregnancy rate (49.6%; 49.2% P=0.70).

CONCLUSION

Subnormal sperm group could obtain the same fertilization rate and pregnancy rate as those of normal group in conventional IVF without ICSI. Generally, ICSI is carried out for subnormal sperm because the possibility of fertilization may decline. But the safety of ICSI has not been proved yet and according to our results, ICSI was not necessarily needed in case of subnormal sperm. Therefore, it seems that conventional IVF without ICSI is sufficient as a fertilization method for subnormal sperm.