Treatment of severe male immunological infertility by intracytoplasmic sperm injection

A total of 29 infertile couples (group A) with male antispermantibodies detected by the mixed antiglobulin reaction (MAR)and partly by flow cytometry (n = 21) were treated using anintracytoplasmic sperm injection (ICSI) technique to assistfertilization. In all, 22 of them had shown a poor fertilizationrate (6%) in previous in-vitro fertilization (IVF) treatments.The fertilization and cleavage rates in ICSI, 79 and 89% respectively,were similar to those in a MAR-negative group (group B; n =20) injected because of male infertility (68 and 93% respectively).A third group (group C; n = 37) with male immune infertilitywas treated by conventional IVF. All these couples had at leastone oocyte fertilized, but the overall fertilization rate (44%)in group C was significantly poorer (P < 0.001) than thatin the two ICSI groups. However, the embryo quality was lowerin group A compared with that in the other groups. A total of13 pregnancies resulted in group A (46%), of which five endedin miscarriage. None of the six pregnancies (30%) in group Baborted during the first trimester. These results reveal, forthe first time, that ICSI offers a good chance of fertilizationfor couples with male immunological infertility. However, post-fertilizationevents may compromise these results because of factors not yetclearly understood.