Objective: To evaluate whether couples with moderate male infertility should be treated with conventional in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI). Patients and Methods: A total of 249 couples with moderate male infertility undergoing their first IVF/ICSI cycle were enrolled in the study. The couples were divided into two groups according to the results of semen analysis: moderate oligozoospermia (O group) and moderate oligoasthenozoospermia (OA group). Sibling oocytes were randomized into groups to be inseminated either by conventional IVF or ICSI. Fertilization rate, embryo quality, implantation rate, and clinical pregnancy rate were examined. Results: There was no difference in the fertilization, implantation, and pregnancy rates between conventional IVF and ICSI in either the O group or OA group (p > 0.05). Additionally, in the OA group, the good quality embryo rate was similar after IVF or ICSI (p > 0.05). However, in the O group, the good quality embryo rate was significantly higher after ICSI than after IVF (p < 0.05). Conclusions: Couples with moderate oligozoospermia or moderate oligoasthenozoospermia did not influence the major indices of IVF. Because of the uncertainties concerning the safety of ICSI, couples with moderate oligozoospermia or moderate oligoasthenozoospermia need not be subjected to this procedure.

1.
World Health Organization: WHO Laboratory Manual for the Examination of Human Semen and Sperm-Cervical Mucus Interaction, ed 4. Cambridge, Cambridge University Press, 1999.
2.
Plachot M, Belaosh-Allart J, Mayenga JM, Chouraqui A, Tesquier L, Serkine AM: Outcome of conventional IVF and ICSI on sibling oocytes in mild male factor infertility. Hum Reprod 2002;17:362-369.
3.
Van der Westerlaken L, Naaktgeboren N, Verburg H, Dieben S, Helmerhorst FM: Conventional in vitro fertilization versus intracytoplasmic sperm injection in patients with borderline semen: a randomized study using sibling oocytes. Fertil Steril 2006;85:395-400.
4.
Arikan II, Demir B, Bozdag G, Esinler I, Sokmensuer LK, Gunalp S: ICSI cycle outcomes in oligozoospermia. Clin Exp Obstet Gynecol 2012;39:280-282.
5.
Nagy ZP, Verheyen G, Tournaye H, Van Steirteghem AC: Special applications of intracytoplasmic sperm injection: the influence of sperm count, motility, morphology, source and sperm antibody on the outcome of ICSI. Hum Reprod 1998;13(suppl 1):143-154.
6.
Sarkar NN: Intracytoplasmic sperm injection: an assisted reproductive technique and its outcome to overcome infertility. J Obstet Gynaecol 2007;27:347-353.
7.
Terada Y, Luetjens CM, Sutovsky P, Schatten G: Atypical decondensation of the sperm nucleus, delayed replication of the male genome, and sex chromosome positioning following intracytoplasmic human sperm injection (ICSI) into golden hamster eggs: does ICSI itself introduce chromosomal anomalies? Fertil Steril 2000;74:454-460.
8.
Schnorr J, Brown S, Oehninger S, Mayer J, Muasher S, Lanzendorf S: Impact of intracytoplasmic sperm injection on embryo cryopreservation and clinical outcome. Fertil Steril 2001;75:636-637.
9.
Macas E, Imthum B, Borsos M, Rosselli M, Maurer-Major E, Keller PJ: Impairment of the developmental potential of frozen-thawed human zygotes obtained after intracytoplasmic sperm injection. Fertil Steril 1998;69:630-635.
10.
Wennerholm UB, Berqh C, Hamberger L, Lundin K, Nilsson L, Wikland M, Källén B: Incidence of congenital malformations in children born after ICSI. Hum Reprod 2000;15:944-948.
11.
Khamsi F, Yavas Y, Roberge S, Wong JC, Lacanna IC, Endman M: Intracytoplasmic sperm injection increased fertilization and good-quality embryo formation in patients with non-male factor indications for in vitro fertilization: a prospective randomized study. Fertil Steril 2001;75:342-347.
12.
Fishel S, Lisi F, Rinaldi L, Lisi R, Timson J, Green S, Hall J, Fleming S, Hunter A, Dowell K: Intracytoplasmic sperm injection (ICSI) versus high insemination concentration (HIC) for human conception in vitro. Reprod Fertil Dev 1995;7:169-174.
13.
Van Der Westerlaken LA, Helmerhorst FM, Hermans J, Naaktgeboren N: Intracytoplasmic sperm injection: position of the polar body affects pregnancy rate. Hum Reprod 1999;14:2565.
14.
Khan MS, Deepa F, Ahmed Z, Tahir F, Khan MA: Assessment of male reproductive health by conventional method of semen analysis. J Ayub Med Coll Abbottabad 2011;23:84-88.
15.
Bukulmez O, Yarali H, Yucel A, Sari T, Gurgan T: Intracytoplasmic sperm injection versus in vitro fertilization for patients with a tubal factor as their sole cause of infertility: a prospective, randomized trial. Fertil Steril 2000;73:38-42.
16.
Hashimoto H, Ishikawa T, Goto S, Kokeguchi S, Fujisawa M, Shiotani M: The effects of severity of oligozoospermia on intracytoplasmic sperm injection (ICSI) cycle outcome. Syst Biol Reprod Med 2010;56:91-95.
17.
Verheyen G, Tournaye H, Staessen C, De Vos A, Vandervorst M, Van Steirteghem A: Controlled comparison of conventional in-vitro fertilization and intracytoplasmic sperm injection in patients with asthenozoospermia. Hum Reprod 1999;14:2313-2319.
18.
Donnelly ET, Lewis SE, McNally JA, Thompson W: In vitro fertilization and pregnancy rates: the influence of sperm motility and morphology on IVF outcome. Fertil Steril 1998;70:305-314.
19.
Turhan N, Pekel A, Ayrim A, Bayrak Ö: ICSI outcome in severely oligoasthenozoospermic patients and its relationship to prewash progressive sperm motility. Turk J Med Sci 2011;41:995-999.
20.
Van der Westerlaken L, Naaktgeboren N, Verburg H, Dieben S, Helmerhorst F: Conventional in vitro fertilization versus intracytoplasmic sperm injection in patients with borderline semen: a randomised study using sibling oocytes. Fertil Steril 2006;85:395-400.
21.
Kihaile PE, Misumi J, Hirotsuru K, Kumasako Y, Kisanga RE, Utsunomiya T: Comparison of sibling oocyte outcomes after intracytoplasmic sperm injection and in vitro fertilization in severe teratozoospermic patients in the first cycle. Int J Androl 2003;26:57-62.
22.
Cai QF, Wan F, Huang R, Zhang HW: Factors predicting the cumulative outcome of IVF/ICSI treatment: a multivariable analysis of 2450 patients. Hum Reprod 2011;26:2532-2540.
23.
Martikainen H, Tiitinen A, Tomás C, Tapanainen J, Orava M, Tuomivaara L, Vilska S, Hydén-Granskog C, Hovatta O: One versus two embryo transfer after IVF and ICSI: a randomized study. Hum Reprod 2001;16:1900-1903.
24.
Ishikawa T, Shiotani M, Izumi Y, Hashimoto H, Kokeguchi S, Goto S, Fujisawa M: Fertilization and pregnancy using cryopreserved testicular sperm for intracytoplasmic sperm injection with azoospermia. Fertil Steril 2009;92:174-179.
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.