SUBZONAL INSEMINATION, PARTIAL ZONA DISSECTION OR INTRACYTOPLASMIC SPERM INJECTION - AN EASY DECISION

This review aims to analyse and compare the results to date of subzona l insemination (SUZI), partial zona dissection (PZD) and intracytoplas mic sperm injection (ICSI) to evaluate critically whether it is now po ssible to replace SUZI and FZD by ICSI. It appears that ICSI is a much more efficient assisted reproduction technique than SUZI and PZD for resolving cases of severe male infertility and/or repeated failure of conventional in-vitro fertilization (IVF). For ICSI compared with SUZI and PZD, fertilization (49.4, 17.7 and 16.8% respectively), percentag e of patients reaching embryo transfer (91.0, 55.1 and 23.3% respectiv ely), percentage of transfers performed with two or three embryos (83. 3% ICSI and 39.3% SUZI), pregnancy rate per embryo replacement (28.2, 18.7 and 16.5% respectively) and pregnancy rate per oocyte retrieval ( 24.8, 10.3 and 3.8% respectively) are all improved. In addition, cases of severely impaired semen characteristics, which were condemned to i nfertility for life with conventional IVF, SUZI or PZD, can now be tre ated and resolved efficiently with ICSI.