Abstract
A protocol for the assessment of oligozoospermia prior to AIH is presented. Three to six carefully performed semen analyses at optimal intervals are required to confirm oligozoospermia. Routine semen analysis consist of volume, pH, viscosity, sperm count, motility, morphology, agglutination, fructose content, and leukocytes. Because of the high incidence of reproductive tract infection and chromosomal abnormalities in oligozoospermic men, microbiological investigation and full chromosomal analyses should be performed in all cases with sperm counts below 10 million/ml. Chromosomal abnormalities are an indication to reject a couple from AIH. Genital tract infections must be treated prior to insemination. Only sperm counts below 10 million/ml require the estimation of FSH levels. The existence of an oligozoospermia group with pituitary adenoma justifies routine PRL measurements in all cases of oligozoospermia and further investigations such as visual field examination and sella tomogram in case of hyperprolactinemia. Testicular biopsy may indicate an epididymal block that can be surgically repaired. Simultaneous in-depth evaluation of the female partner is emphasized, as oligozoospermia in the man does not rule out the possibility of an additional infertility factor in his partner. It is still controversial whether or not AIH, as compared to intercourse, will improve the conception rate for oligozoospermic men.
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