SPERM STIMULANTS CAN IMPROVE FERTILIZATION RATES IN MALE-FACTOR CASESUNDERGOING IVF TO THE SAME EXTENT AS MICROMANIPULATION BY PARTIAL ZONA DISSECTION (PZD) OR SUBZONAL SPERM INSEMINATION (SUZI) - A RANDOMIZED CONTROLLED-STUDY

Purpose Our purpose was to evaluate the efficacy of direct inseminatio n (IVF), micromanipulation by partial zona dissection (PZD), and subzo nal sperm insemination (SUZI) using sperm-treated with pentoxifylline (PF) +/- 2-deoxyadenosine (2DA). Results: The overall fertilization ra te achieved was similar for all three fertilization techniques (33.1, 30.2, and 26.9% for IVF, SUZI, and PZD, respectively). Patients who ha d reduced fertilization in previous IVF attempts showed improved ferti lization with sperm stimulants, either PF alone or PF in combination w ith 2DA in standard IVF. In certain cases, SUZI or PZD gave significan tly improved fertilization rates in comparison to IVF. Conclusion: Sel ective use of sperm stimulants in IVF can achieve fertilization for th e majority of male-factor cases. However, PZD and SUZI techniques are useful, especially when sperm stimulants fail to achieve fertilization or achieve poor fertilization in direct insemination.