SUBZONAL SPERM INSEMINATION AND TOTAL OR EXTREME ASTHENOZOOSPERMIA - AN EFFECTIVE TECHNIQUE FOR AN UNCOMMON CAUSE OF MALE-INFERTILITY

Objective: To assess the value of subzonal insemination (SUZI) in case s of total or extreme asthenozoospermia. Design: The results of IVF af ter SUZI were assessed in six cycles (four couples) with documented as thenozoospermia. Setting: Institut de Medecine de la Reproduction, Mar seille, France. Patients: Four couples underwent six retrieval cycles. In all cases asthenozoospermia was total (100% of immotile spermatozo a) or extreme (5% nonprogressive motility). Oligozoospermia and terato zoospermia were ruled out in all cases. In two cases electron microsco py revealed the absence of the central singlet in the flagellum axonem al complex and in one case a major dysplasia of the fibrous sheath in the flagellum principal piece. Results: The overall fertilization rate was 45%. The diploid embryo rate was 33%. Embryo quality was satisfac tory. In five of six cycles, three embryos were transferred. Two tripl et pregnancies were obtained corresponding to an implantation rate per transferred embryo of 40%. Conclusion: Total or extreme asthenozoospe rmia seems to be a good indication for SUZI.