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Abstract
A recent study suggested that oligoasthenozoospermia may be an etiologic factor for spontaneous abortion (SAB) after in vitro fertilization-embryo transfer (IVF-ET). However, IVF-ET with intracytoplasmic sperm injection (ICSI) did not seem to be associated with an increased SAB rate. The study presented herein compared the rate of SAB in pregnancies achieved by IVF-ET according to the type of oocyte insemination process. The 3 types evaluated were conventional insemination, which exposed the oocyte to 25,000 sperm with prolonged contact (16-24 h), intermediate contact with a short insemination protocol where contact with 25,000 sperm was limited to 2 h, and very limited contact with ICSI, where only 1 sperm was injected into the oocyte thus not exposing the zona pellucida to any sperm. The patients were further subdivided into age groups of 39 or 40. SAB rates after frozen ET were also evaluated. The clinical pregnancy and SAB rates following fresh or frozen ET for conventional, ICSI, and short insemination techniques for the 2 age groups were comparable. These data question whether oligoasthenozoospermia may be a factor in causing SAB, and whether avoidance of contact with the zona pellucida by using ICSI can negate this effect. A larger study is needed.