INTRACYTOPLASMIC SPERM INJECTION FOR TREATING INFERTILITY ASSOCIATED WITH SPERM AUTOIMMUNITY

Objective: To determine whether intracytoplasmic sperm injection (ICSI ) can be used to achieve normal fertilization, embryo cleavage, and pr egnancies in cases of sperm autoimmunity. Design: A retrospective anal ysis of ICSI results in sperm antibody-positive and randomly selected antibody-negative groups. Setting: University- and hospital-based repr oductive research laboratory and tertiary referral IVF program. Patien t(s): Thirty-nine couples selected on the basis of a strongly positive result for sperm antibodies of immunoglobulin (Ig) G and/or IgA immun oglobulin class in the male partner and a control group of 140 antibod y-negative couples. Intervention(s): Human menopausal gonadotropin, hC G and Lucrin (Abbott Australasia, Kurnell, NSW, Australia) were given by injection. Oocyte collection was by transvaginal ovarian puncture. Blood was collected for beta-hCG measurement. Main Outcome Measure(s): Normal fertilization, embryo cleavage, establishment of clinical preg nancy, and delivery. Result(s): There were no significant differences in fertilization rates (62% versus 58%) or clinical pregnancy rates (1 9% versus 12%) between sperm antibody-positive and sperm antibody-nega tive patient groups. Conclusion: Intracytoplasmic sperm injection is a n effective treatment for patients with severe sperm autoimmunity. (C) 1997 by American Society for Reproductive Medicine.