Relationship between the sperm motility index assessed by the sperm quality analyzer and the outcome of intracytoplasmic sperm injection

Purpose: Intracytoplasmic, sperm injection (ICSI) has been validated as a u seful treatment in severe male-factor patients who could not achieve fertil ization and live births by conventional in vitro fertilization treatment. T o examine the impact of male factors on ICSI outcome, clinical laboratory d ata were retrospectively analyzed Methods: One hundred two cycles of ICSI treatment indicated by severe male- factor infertility were entered into this study: Sperm parameters including sperm motility sperm concentration, and sperm motility index assessed by t he Sperm Quality Analyzer were evaluated. Results: Five hundred seventy-six metaphase II oocytes retrieved were manip ulated. The normal fertilization (2 PN) rate per oocyte was 64.9 +/- 26.0% (mean +/- SD). Of the 99 transfers, 31 clinical pregnancies were obtained y ielding an average pregnancy rate of 31.3% per transfer. The mean sperm mot ility, sperm concentration and sperm motility index were 20.3 +/- 16.1% (ra nge, 0 to 50%), 18.2 +/- 25.1 x 10(6)/ml (range, <1 to 150 x 10(6)/ml), and 31.2 +/- 45.0 (range, 0 to 220), respectively Sperm concentration did not have a significant impact on fertilization rate by ICSI. In four cases, ICS I was performed using totally immotile sperm and the fertilization rate was 43.5%, which was significantly lower than that of some of the other sperm motility groups, and no pregnancy could be achieved. In 14 cases in which t he sperm motility index assessed by the Sperm Quality Analyzer was 0, the f ertilization rare (50.0%) was significantly lower than in most of the other sperm motility index groups. Conclusions: These findings suggest that in severe malefactor cases with to tally immotile sperm or a sperm motility index of 0, the selection of good- quality sperm should be verified before injection.