EVIDENCE THAT OLIGOASTHENOZOOSPERMIA MAY BE AN ETIOLOGIC FACTOR FOR SPONTANEOUS-ABORTION AFTER IN-VITRO FERTILIZATION-EMBRYO TRANSFER

Objective: To evaluate whether oligoasthenozoospermia may lead to a hi gher spontaneous abortion (SAB) rate once a pregnancy is established b y IVF-ET. Design: Retrospective clinical observational study. Setting: University-based IVF program. Patient(s): Three hundred sixty-four co uples with normal semen parameters who underwent IVF-ET with conventio nal sperm incubation; 70 couples with oligoasthenozoospermia but witho ut marked abnormal sperm morphology (<4% normal forms using strict cri teria) who underwent ET after IVF with conventional sperm incubation; and 20 couples with oligoasthenozoospermia but without abnormal sperm morphology who underwent ET after IVF with intracytoplasmic sperm inje ction (ICSI). Main Outcome Measure(s): Implantation rate, clinical pre gnancy rate, SAB rate, and delivery rate after IVF-ET. Result(s): Desp ite similar pregnancy and implantation rates per ET, as a result of a higher SAB rate (40.0% versus 11.7%), the delivery rates were lower in the female partners of men with oligoasthenozoospermia. Similar patie nts who used ICSI had a 0% SAB rate. Conclusion(s): Oligoasthenozoospe rmia should be considered a possible risk factor for SAB in IVF achiev ed pregnancies. Further studies are needed to determine whether ICSI r educes the risk of SAB associated with oligoasthenozoospermia. (C) 199 7 by American Society for Reproductive Medicine.