Pregnancies after microinjection of human spermatozoa into human oocytes.

The use of In-Vitro Fertilisation (IVF) has become an accepted treatment for couples with male factor infertility!. However, there must be adequate number of motile spermatozoa it there is to be a favourable outcome. The introduction of Intra Cytoplasmic Sperm Injection (ICS!) technique by Palermo et aP has encouraged an increase in the clinical use of the procedure in men with very poor semen parameters. We present our initial experience with this technique. Twelve patients underwent initial treatment. Ovarian stimulation was performed with a combination of gonadotrophin hormone releasing hormone (GnRh) analogue and hMG and/or Metrodin. A total of 89 oocytes were obtained by transvaginal aspiration. Seventy-six oocytes were noted to be in metaphase II and 13 in metaphase I (they were allowed to mature to metaphase 11 stage) with their respective cumulus cells and corona radiata. The husbands were asked to produce a semen sample on the day of oocyte pickup. A combination of sperm preparation techniques (either percoll gradient or swim-up technique) were used to recover as many motile sperms as possible. A total of 83 metaphase 11 oocytes were injected with a single sperm using micropipettes controlled by two Narishige (Narishige USA, Inc) micromanipulators. Fertilisation was noted in 69 oocytes (83%). Thirteen excess good quality embryos from 2 patients were cryopreserved for use at a later date. Eleven patients had a total of 43 embryos transferred (one patient had no fertilisation from the only oocyte obtained). This resulted in 7 pregnancies (63.6%) per embryo transfer (ET), the outcome of which to date are as follows: