The postwash total progressively motile sperm cell count is a reliable predictor of total fertilization failure during in vitro fertilization treatment

Objective: To predict the chance of total fertilization failure (TFF) befor e the day of ovum pickup with known semen and female variables. Design: A statistical model was constructed to predict TFF by retrospective analysis (2,366 couples) and subsequently tested on a new IVF population ( 917 couples). Setting: Academic tertiary referral center. Patient(s): Three thousand three hundred eighty-three couples who underwent an IVF-ET treatment. C Intervention(s): None. Main Outcome Measure(s): The ability to predict the probability of TFF in I VF. Result(s): Two variables-postwash total progressively motile sperm cell cou nt (postwash TPMC and number of follicles-were found to be significant. Tak ing a probability of 25% as an acceptable risk of TFF, we calculated that a postwash TPMC of <1.1 x 10(6) cells results in a risk of TFF of > 25%. Low responders (<4 follicles) needed a postwash TPMC of >2.2 x 10(6) cells to reduce the risk of TFF to < 25%. High responders (> 15 follicles) needed on ly 0.35 x 10(6) postwash progressively motile spermatozoa. Conclusion(s): When postwash TPMC and number of follicles are known and an unacceptable TFF outcome is expected, one can propose an ICSI procedure a f ew days before the day of ovum pick-up. (C) 2001 by American Society for Re productive Medicine.