Subzonal insemination: a prospective randomized study in patients with abnormal sperm morphology.

OBJECTIVE

To evaluate in a prospective randomized study the outcome of subzonal insemination (SUZI) in patients with male subfertility.

DESIGN

In a period of 7 months, 48 patients underwent IVF treatment for male subfertility reasons. Normal insemination and SUZI were performed on sibling oocytes. Patients were divided into three groups depending on the sperm morphology (strict criteria): group 1, 10% to 14%; group 2, 5% to 10%; group 3, 0% to 5%.

SETTING

Private fertility center in Leuven, Belgium.

MAIN OUTCOME MEASURES: The fertilization rates, cleavage rates, implantation rates, and pregnancy rates between the normally inseminated and the SUZI-treated group were compared.

RESULTS

The fertilization rate with SUZI was significantly higher (32%) than after normal insemination (7%). The difference was striking in groups 2 and 3 (35% and 33% versus 11% and 4%).

CONCLUSION

This study indicates that SUZI increases the fertility outcome in patients with male subfertility and that there is a marked difference in fertilization rate when morphology, using strict criteria, is < 10%.