A RANDOMIZED STUDY OF INTRACYTOPLASMIC SPERM INJECTION (ICSI) VERSUS SUBZONAL INSEMINATION (SUZI) FOR THE MANAGEMENT OF SEVERE MALE-FACTOR INFERTILITY

Objective: Our objective was to compare the fertilization rates achiev ed by ICSI versus SUZI in couples with severe male infertility. Design : This was a randomized, prospective study. Setting: The study took pl ace at the In-Vitro Fertilization-Embryo Transfer Unit, Department of Obstetrics and Gynecology, The Chaim Sheba Medical Center. Materials a nd Methods: Oocytes of 12 patients,were randomly allocated to either I CSI or SUZI procedures. Each woman thus served as her own control. All 12 patients had undergone at least two previous in vitro fertilizatio n cycles with no fertilization or had a very low sperm count, i.e., a total motile sperm count of less than 0.5 x 10(6). Results: A total of 117 oocytes was obtained for fertilization, Of these oocytes, 16% (10 /63) were successfully fertilized by SUZI, compared to 33% (18/54) tre ated by ICSI. This difference was statistically significant (P < 0.05) . Of the 12 cycles, ICSI provided embryos in 10 cycles (83%, while SUZ I was successful in only 6 cycles (50%). Four pregnancies were achieve d: 33% per attempt, or 40% per transfer.