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Interet de la microinjection de spermatozoides sous la zone pellucide pour le traitement de certaines sterilites masculines

Sub-zonal sperm microinjection as a treatment for certain types of male factor infertility

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Abstract

Sub-zonal insemination (SUZI) was evaluated, in a randomized prospective study, as a treatment for certain specific types of male factor infertility. Patients were classified according to the results of an extensive semen analysis as being either IVF failure with either normal or subnormal semen quality, specific (e.g. absent outer dynein arms) or non-specific flagellar dyskinesia, or oligoasthenoteratozoospermia. SUZI was found to be an efficient technique for achieving fertilization and pregnancy for all these indications, while there was a total failure of fertilization in the control, in-vitro inseminated oocytes. A total of 395 oocytes were microinjected and 133 fertilized, among which 75 (19% overall) were diploid. More than 81% of these zygotes cleaved normally, and 31 embryo transfers resulted in seven pregnancies. However, results varied widely between the various indications, suggesting that the underlying pathology responsible for the sterility may influence gamete interaction and early embryonic development independantly of the SUZI technique.

Resume

Parmi les méthodes de microfécondation, la microinjection de spermatozoïdes sous la zone pellucide (SUZI) a été testée au cours d’une étude prospective et randomisée pour différentes pathologies responsables de stérilités d’origine masculine. Les résultats de ces études ainsi que des premières séries de patients inclus dans ce programme sont présentés. Nous distinguons, les échecs de FIV à sperme normal ou subnormal, les dyskinésies flagellaires d’origine structurale comme les absence de bras externes de dynéine ou non spécifiques. Enfin une petite série concerne les oligoasthénotératospermies. Dix neuf pour cent des ovocytes ont été fécondés normalement, et sept grossesses ont été obtenues à partir de 31 transferts d’embryons. Les résultats sont cependant très variables d’une indication à l’autre.

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Correspondence to Jean-Philippe Wolf.

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Wolf, J., Kunztmann, J., Feneux, D. et al. Interet de la microinjection de spermatozoides sous la zone pellucide pour le traitement de certaines sterilites masculines. Androl. 2, 16–18 (1992) doi:10.1007/BF03034588

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Key words

  • Male infertility
  • subzonal insemination
  • IVF failure
  • absent dynein arms
  • oligoasthenoteratozoospermia failed fertilization?

Mots clés

  • Microinjection
  • Echec de FIV
  • Absence de bras externes de dynéine
  • Oligoasthénospermie
  • Stérilité masculine