4000 cases of intrafallopian transfer of ova immediately after intracytoplasmic sperm injection (RAPID ICSI-ZIFT) for treatment of severe male factor infertility.

Abstract

Objective: Gamete Intrafallopian Transfer (GIFT) is a well-established technique of assisted conception and as the technique of choice for infertile couple with patent fallopian tubes although Gift lost popularity because of its requirement of a fully equipped operating room and improving in-vitro embryo culture system. But it still offers a high pregnancy rate in the hands of well trained personnel probably because of more physiologic environment of the tubal epithelium. We presented probably for the first time the treatment of 100 couples with severe Male Factor infertility in 16th world congress and 54th annual meeting of ASRM 1998. We endeavor to show that Gamete Intrafallopian Transfer of ova immediately after intracytoplasmic sperm injection (RAPID ICSI ZIFT) is a treatment for severe Male Factor Infertility.Design: A retrospective study of 4000 consecutive RAPID ICSI ZIFT cases conducted in a private and university ART centers during a 54 month period from July 1996 to December 2000.Materials/Methods: 4000 couples were selected in whom severe Male Factor was the primary infertility diagnosis. Semen was collected after masturbation (N#2300), microscopic epididymal sperm aspiration (MESA) (N#460), percutaneous sperm aspiration from the epididymis (PESA) (N#830) or testical (TESA) (N#215) and vibratone assisted ejaculation (N#195). 2480 semen samples collected, exhibited two or more suboptimal sperm parameters. 2200 samples contained sperm concentration which were < 3 mil, 2000 samples with 15% forward progressive sperm and suboptimal morphology in 2440 samples. Females 25 to 45 years of age exhibited tubal patency as determined by hystrosalpingogram and laparascopy. All patients had been stimulated with LH/RH agonist Buserlin (Suprefact) HMG combinations in the form of a long protocol and transvaginal ultrasound guided oocyte retrieval, ICSI and laparascopic tubal transfer.Results: In average 10 oocyte per collection was retrieved and a mean of 5.5 post ICSI-OVA were transferred the remaining oocyte were fertilized by ICSI and cryopreserved. Clinical pregnancy rate for the above series was 46% (1840/4000) the average age of female patients was 35.4% and multiple pregnancy rate was 22.2%.Conclusions: Success of tubal transfer for post ICSI ova is related to maternal age (ova number and quality) and the programs’ rate of fertilization and embryo development and in the hand of well-trained personnel can afford the severe Male Factor patients high chance of success.Supported By: Grant in the memorial of Navid Sahebkashaf by Navid’s institute of infertility. Objective: Gamete Intrafallopian Transfer (GIFT) is a well-established technique of assisted conception and as the technique of choice for infertile couple with patent fallopian tubes although Gift lost popularity because of its requirement of a fully equipped operating room and improving in-vitro embryo culture system. But it still offers a high pregnancy rate in the hands of well trained personnel probably because of more physiologic environment of the tubal epithelium. We presented probably for the first time the treatment of 100 couples with severe Male Factor infertility in 16th world congress and 54th annual meeting of ASRM 1998. We endeavor to show that Gamete Intrafallopian Transfer of ova immediately after intracytoplasmic sperm injection (RAPID ICSI ZIFT) is a treatment for severe Male Factor Infertility. Design: A retrospective study of 4000 consecutive RAPID ICSI ZIFT cases conducted in a private and university ART centers during a 54 month period from July 1996 to December 2000. Materials/Methods: 4000 couples were selected in whom severe Male Factor was the primary infertility diagnosis. Semen was collected after masturbation (N#2300), microscopic epididymal sperm aspiration (MESA) (N#460), percutaneous sperm aspiration from the epididymis (PESA) (N#830) or testical (TESA) (N#215) and vibratone assisted ejaculation (N#195). 2480 semen samples collected, exhibited two or more suboptimal sperm parameters. 2200 samples contained sperm concentration which were < 3 mil, 2000 samples with 15% forward progressive sperm and suboptimal morphology in 2440 samples. Females 25 to 45 years of age exhibited tubal patency as determined by hystrosalpingogram and laparascopy. All patients had been stimulated with LH/RH agonist Buserlin (Suprefact) HMG combinations in the form of a long protocol and transvaginal ultrasound guided oocyte retrieval, ICSI and laparascopic tubal transfer. Results: In average 10 oocyte per collection was retrieved and a mean of 5.5 post ICSI-OVA were transferred the remaining oocyte were fertilized by ICSI and cryopreserved. Clinical pregnancy rate for the above series was 46% (1840/4000) the average age of female patients was 35.4% and multiple pregnancy rate was 22.2%. Conclusions: Success of tubal transfer for post ICSI ova is related to maternal age (ova number and quality) and the programs’ rate of fertilization and embryo development and in the hand of well-trained personnel can afford the severe Male Factor patients high chance of success. Supported By: Grant in the memorial of Navid Sahebkashaf by Navid’s institute of infertility.