IVF-ET Does Not Improve Live Delivered Pregnancy Rates vs Intrauterine Insemination Despite Mild Oligoasthenozoospermia in Women with Very Severe Diminished Oocyte Reserve
Jerome H Check*, Carrie Wilson, Wendy Hourani, Danya Horwath and Naomi Ganpo-Nkwenkwa
ABSTRACT
Background: Though fecundity is markedly reduced in women with severely diminished oocyte reserve (DOR), nevertheless live deliveries are still possible. The objective of this study was to determine how much, if any, does in vitro fertilization (IVF) increase the chance of a live delivery in the presence of DOR complicated by the male partner having oligoasthenozoospermia. Though a reasonable pregnancy rate is usually found in the presence of oligoasthenozoospermia with intrauterine insemination (IUI) and even intercourse, lower egg quality could make it more difficult for lower quality sperm to achieve a pregnancy naturally.
Materials and Method: The study group consisted of women with marked DOR as evidence by a serum anti-mullerian hormone (AMH) level <0.5ng/ml whose male partner had mild oligoasthenozoospermia. They were given the option of IVF or IUI. If they chose IVF, they were randomly assigned to have intracytoplasmic sperm injection (ICSI) or conventional oocyte insemination. Only women with one dominant follicle were selected
Results: The results showed a 3% chance of a live delivery from IUI to IVF in one treatment cycle. ICSI did not improve outcome any better than conventional oocyte insemination. Conclusion: These results thus suggest that with infertile couples where the female partner has severe DOR and the male has mild oligoasthenzoospermia, there does not appear to be any advantage of spending much more money to have IVF with or without ICSI.
