Very low sperm count affects the result of intracytoplasmic sperm injection

Purpose: The aim was to examine the influence of extremely low sperm count on intracytoplasmic sperm injection (ICSI) outcome. Methods: Over 1000 consecutive unselected ICSI cycles were divided into fou r groups according to sperm concentration of their patients: A, crytozoospe rmia, 107 patients; B, sperm concentration of less than or equal to 1 X 10( 4), 146 patients; C, sperm count of 1 X 10(4)-1 X 10(5), 135 patients; and concentration of > 1 x 10(5) and < 10 x 10(6)/ml (control group), 688 patie nts. Results: A significant decrease in pregnancy rate was noticed in the crypto zoospermic group in comparison to the control group (20% vs. 31%). Fertiliz ation rate in group A was significantly lower in comparison to all other gr oups, respectively (46% vs. 52%, 54%, 61%). Embryo quality was inferior in group A in comparison to the control group. A higher ver not statistically significant abortion rate was observed in the cryptozoospermic group (as we ll as in group C) (30%, 27%) compared to the control group (15%). Conclusions: It seems that an extremely low sperm count has a negative effe ct on the outcome of ICSI. Nevertheless patients with cryptozoospermia shou ld not be offered ICSI treatment with the ejaculated sperm before karyotype is established.