Pregnancy outcome of in vitro fertilization/intracytoplasmic sperm injection with profound teratospermia

OBJECTIVE: To assess the pregnancy outcome of IVF with intracytoplasmic sperm injection (ICSI) in couples with profound teratospermia (Kruger's strict criteria of zero). DESIGN: Retrospective analysis of 545 consecutive cycles of IVF/ICSI performed between January 2000 and January 2003. SETTING: Tertiary care center. PATIENT(S): Of 545 IVF/ICSI cycles, 45 patients were identified with a semen strict morphology of 0 using Kruger's strict criteria. INTERVENTION(S): Ovarian down-regulation (Lupron) was followed by controlled ovarian stimulation exclusively with hMG. Embryo transfer was performed 2 days after transvaginal aspiration/ICSI. MAIN OUTCOMES MEASURE(S): Pregnancy outcomes and newborn/infant status. RESULT(S): Of 45 patients undergoing 54 treatment cycles, 21 patients were positive for pregnancy (38.9% pregnancy/cycle). No birth defects were noted at time of delivery and all infants had obtained appropriate developmental milestones at 1 year of age. CONCLUSION(S): Men with profound teratospermia (Kruger's strict criteria of zero) may achieve acceptable pregnancy rates after IVF/ICSI thereby alleviating the use of donor sperm in this group. Furthermore, no increased risk of birth defects is apparent in this small series.