TREATMENT OF SEVERE MALE IMMUNOLOGICAL INFERTILITY BY INTRACYTOPLASMIC SPERM INJECTION

A total of 29 infertile couples (group A) with male antisperm antibodi es detected by the mixed antiglobulin reaction (MAR) and partly by flo w cytometry (n = 21) were treated using an intracytoplasmic sperm inje ction (ICSI) technique to assist fertilization, In all, 22 of them had shown a poor fertilization rate (6%) in previous in-vitro fertilizati on (IVF) treatments, The fertilization and cleavage Fates in ICSI, 79 and 89% respectively, were similar to those in a MAR-negative group (g roup B; n = 20) injected because of male infertility (68 and 93% respe ctively), A third group (group C; n = 37) with male immune infertility was treated by conventional IVF, All these couples had at least one o ocyte fertilized, but the overall fertilization rate (44%) in group C was significantly poorer (P < 0.001) than that in the two ICSI groups, However, the embryo quality was lower in group A compared with that i n the other groups, A total of 13 pregnancies resulted in group A (46% ), of which five ended in miscarriage. None of the six pregnancies (30 %) in group B aborted during the first trimester, These results reveal , for the first time, that ICSI offers a good chance of fertilization for couples with male immunological infertility, However, post-fertili zation events may compromise these results because of factors not yet clearly understood.