1998 Volume 29 Issue 3 Pages 271-281
We attempted an integrated assessment of male infetility by combining multiple parameters of semen and serum, and tried to select patients requireing intracytocplasmic sperm injection (ICSI). Significant correlations were demonstrated between the rate of fertilization by human in vitro fertilization (IVF) and five parameters, consisting of sperm concentration, a mortility and a proportion of morphologically normal sperm in semen, a rate of fertilization with the hamster test, and the serum concentration of FSH (R-square=0.627). According to the results of these five parameters, a male factor index (MFI) was calculated and relations between MFI and IVF outcomes were further analyzed. There were significant differences among three groups of patients with MFI of 0, 1-2 and 3-5 (20, 95 and 431 cycles, respectively) in the rates of fertilization (26.5, 51.3 and 65.2 %, respectively), embryo transfer (30, 78 and 92.6%, respectively), and ongoing pregnancy (0, 18 and 28.3%, respectively). The rate of abortion was significantly higher in patients with MFI 0 than in ones with MFI 1-5 (100 and 19 %, respectively). Fiftyfour cycles of ICSI were performed in patients with MFI 0 and significant improvement was obtained in the rates of fertilization, embryo transfer, ongoing pregnancy and abortion (63.0, 98, 26 and 6.7%, respectively), compared with IVF outcomes in patients with MFI 0. The study has shown that MFI is useful to predict IVF outcomes and that patients with MFI 0 should be treated by ICSI.
