SUCCESSFUL TREATMENT OF SEVERE OLIGOZOOSPERMIA WITH SPERM WASHING ANDINTRAUTERINE INSEMINATION

During the period January 1, 1991 through December 31, 1995, 258 patie nts, in whom motile sperm counts for insemination (postwash, processed ) were 10.0 million motile sperm or less were seen in the andrology un it for sperm washing and intrauterine insemination (IUI). No significa nt female factors were noted on history; all female partners had paten t Fallopian tubes and were ovulatory spontaneously or were treated by the referring gynecologist with clomiphene citrate, human menopausal g onadotropin (hMG), or follicle-stimulating hormone (FSH) ovulation ind uction in both anovulatory or ovulatory women. Of the total of 258 pat ients, 15 achieved a pregnancy in 284 cycles of IUI in which the insem inating motile count was <1.0 million motile sperm, resulting in a mon thly fecundity (f) of 5.3%. The mean (+/-SD) motile count for IUI in t his group was 0.61 (+/-0.29) million sperm, with a range of 0.19-0.95 million motile sperm. The initial motile count was 2.97 (3.2) million sperm, with a range of 0.2-12.81 million sperm. With inseminating moti le counts of 1.0-10.0 million motile sperm, there were 83 pregnancies after 467 cycles of IUI, resulting in a monthly f of 17.8%. The mean ( +/-SD) motile count for IUI in this group was 4.9 (+/-2.7) million mot ile sperm with a range of 1.0-9.9 million motile sperm. The initial sp erm count in this group was 10.9 million (+/-7.1), with a range of 1.1 -23.7 million motile sperm. These data suggest that acceptable pregnan cy rates can be achieved with IUI, even in severely oligozoospermic sp ecimens. Intrauterine insemination is less invasive and less costly th an other assisted reproductive techniques. These data are supportive o f IUI prior to attempting other more invasive and potentially costly r eproductive technologies.