Micro-assisted fertilization in patients who have failed subzonal insemination |
| |
| Authors: | Fishel, Simon Timson, Judy Lisi, Franco Jacobson, Merwyn Rinaldi, Leonardo Gobetz, Lawrence |
| |
| Affiliation: | 1NURTURE (Nottingham University Research and Treatment Unit in Reproduction), Department of Obstetrics & Gynaecology, Floor ‘B’ East Block, University Hospital, Queen's Medical Centre Nottingham NG7 2UH, UK 2BIOGENESI Clinica Europa, Viale Eufrate, Roma, Italy 3Vitalab, Linksfield Park Clinic Twelfth Avenue, Linksfield West 2192, South Africa |
| |
| Abstract: | During the past 3 years we have used direct injection of spermatozoainto the cytoplasm of the oocyte (DISCO) in an attempt to procureconception in vitro where subzonal insemination (SUZI) has failed,Acknowledging the paucity of information about this invasiveprocedure in humans, it was clearly the only alternative forsome patients. A total of 58 patients (cycles) who had had previouslyfailed SUZI elected for this approach. Sibling oocytes, wherepossible, were used as a comparison between DISCO, SUZI, partialzona dissection (PZD) and microdrop invitro fertilization(IVF). Fertilization and embryo transfer was achieved by 66%(n = 38) of patients. Patients with embryos derived solely fromDISCO (n = 19) produced four clinical pregnancies (21%), fourpatients had embryo transfer from SUZI embryos only with nopregnancies, and 15 had embryo transfer from a mixture of SUZIand DISCO embryos, with one dizygotic twin pregnancy from acombined SUZI and DISCO embryo transfer (7%). Twins, one maleand one female, have been delivered, there has been one miscarriageand two pregnancies are ongoing. Of the 627 oocytes, 251 wereused for DISCO and 71 (28%) were fertilized, 296 were used forSUZI and 29 (10%) were fertilized; 70 were used for PZD, two(3%) were fertilized. and none of the 10 undergoing microdropIVF were fertilized. Of the 58 patients (cycles) 31% (n = 19)had fertilization with DISCO only, 8% (n = 4) with SUZI only,28% (n = 15) with both SUZI and DISCO, while only one (2%) hadfertilization with PZD. The incidence of fertilization in sampleswith <5% normal forms was higher (37%) after DISCO than SUZI(15%). Of four cases with globozoospermia one achieved fertilizationwith DISCO only, and of cight cases of 100% immotile spermatozoa,two achieved fertilization with DISCO only and one with SUZIand DISCO. We conclude from this series of patients that DISCOmay not only be an advantage when SUZI fails but may becomethe first microassisted fertilization approach |
| |
| Keywords: | intracytoplasmic injection of spermatozoa/micro-assisted fertilization/subzonal insemination |
| 本文献已被 Oxford 等数据库收录！ |
|
