PRE-ICSI SYSTEMATICALLY GRADED ASSESSMENT OF SPERM MOTILITY PREDICTS CLINICAL OUTCOMES IN SEVERE OLIGOSPERMIC AND AZOOSPERMIC MALES

For males with severe oligospermia or those using sperm extracted from the epididymis testis identifying characteristics that are associated a successful live birth after IVF/ICSI would be valuable for patient counseling. A total of 243 ICSI cycles were performed epididymal (ES; n= 52), testicular (TS; n=64) men (OS; 127), having one million fewer per ml. Sperm assessments made prior to initiating oocyte stimulation. If counts too low count on Makler chamber, 5 μl aliquot was examined and average motile high powered field (hpf) counted. no observed in fields, entire ul drop screened sperm. In absence sperm, additional aliquots totaling 20 assessed. IVF cycle data retrospectively stratified into 4 groups by severity deficiency; Group I: 0.1 1 mill motile/ml, 2: ≥ sperm/hpf ,Group 3: sperm/ ul, 4: ≥1 / rare We further quality motility (A-D) within each group, where A=forward motility, B =distinct twitching movement place , C=slight sway, D=non-motile. Four used frozen ES TS Primary outcome measures percent fertilization, clinical pregnancy, implantation rates. Differences between compared chi-square test one-way ANOVA. P-values <0.5 considered statistically significant. Tabled 1Group10.1- 1mill/ml2≥ hpf3≥ μl4≥ μlp-valueRetrievals100517814Transfers94497614Patient age at retrieval33.4 ± 4.633.1 5.233.6 4.233.4 5.0NSSperm sourceOS853372ES113290TS4163212Mature oocytes11.3 6.211.5 5.811.46 6.311.9 6.1NSFertilization rate (%)69.071.067.340.1<0.00001Embryos transferred1.63±0.731.75 0.661.76 0.702.29 0.830.016Clinical pregnancy (%)50.059.256.635.7NSImplantation (tot ET/tot sacs)36.243.841.615.60.030Live (%)44.757.152.628.6NS Open table new tab grade significantly affected fertilization (p<0.0001) : D ,42.5% versus 68.8%,60.5%, 63.6% qualities A-C classified as had worst prognosis terms non-motile also lowered overall