Research Article - Gynecology and Reproductive Endocrinology (2018) Volume 2, Issue 1
The use of semen parameters to decide between conventional in vitro fertilization (IVF) and IVF combined with intracytoplasmic sperm injection (ICSI).
Background: In vitro fertilization (IVF) with intracytoplasmic sperm injection (ICSI) has been increasingly used to treat an expanding subset of infertile patients; However, IVF/ICSI is not without inherent risks. The goal of this study was to determine if pre-wash and/or post-wash semen parameters are useful in determining the best method of fertilization between IVF and ICF/ICSI. Methods and Findings: A retrospective chart review was performed on 211 cycles performed at the UHealth Reproductive and Fertility Center at the University of Miami Hospital between the years of 2008-2014. 126 of those cycles were performed with ICSI and the remaining 85 were performed with conventional IVF. The volume, concentration, and motility for each semen sample were measured. These semen parameters were used to calculate total motile count (TMC), volume (ml), concentration (million/ml), and motility (percentage). This was done in both prewash and post-wash samples. We compared patient characteristics, pre/post-wash parameters, and outcomes for IVF with conventional fertilization vs. IVF/ICSI. The main outcome studied was fertilization rate. A receiver operating characteristic (ROC) curve analysis determined that a post-wash threshold of 25 million TMC achieved a 70% fertilization rate in conventional IVF patients. This rate is comparable to that achieved with ICSI. Conclusion: There is evidence to show that pre-wash and post-wash parameters of total motility count of sperm can be used to make decisions regarding use of conventional fertilization versus ICSI in patients undergoing IVF.Author(s): Saad NM, Krishnamoorthy K, Kwal J, Brackett N and Attia G