RESUMO
Background: Semen analysis is the basic step when investigating sub fertility disorders related to male genital tract. Valuable clinical information can be obtained from Semen analysis report about the spermatogenesis and functional capabilities of spermatozoa
Objective: To determine the fertilization rate and pregnancy outcomes among intracytoplasmic sperm injection patients and its association with sperm parameters
Methodology: This retrospective analytical study was carried out at Lahore Institute of Fertility and Endocrinology, Lahore. Male partners of 272 couples were included in the study as they came for evaluation for assisted reproduction in between 1st July and 31st December 2014. Before samples were collected these males were asked to remain abstinent for 3 days. Specimens were collected by masturbation, and in cases of azoospermia it was retrieved by Percutaneous Epididymal Sperm Aspiration [PESA] or Testicular Sperm Apiration [TESA]. Semen analysis was performed according to the methods and standards outlined by the World Health Organization [WHO]. Oocytes were aspirated after 35-36 hours approximately, by ultrasound-guided transvaginal retrieval. About 4-5 hours after the aspiration of oocyte, in the IVF cycles, they were inseminated. After 18 to 20 hours all oocytes were examined for pronuclei followed by cleavage assessment within 24 hours. Embryos were examined and best embryos two or three were transferred into the uterine cavity on the 3rd day
Results: Fertilization did occurred in 182 [95.8%] patients with normal sperm count, in 30 [90.9%] with subnormal sperm count and in 43 [87.8%] with Azoospermia. Fertilization did occur in 209 [95.4%] patients with normal sperm morphology, in 12 [92.3%] with subnormal sperm morphology and in 34 [85.0%] with Azoospermia. Fertilization did occur in 160 [98.2%] patients with normal sperm motility, in 59 [88.1%] with subnormal sperm motility and in 36 [85.7%] in the Azoospermia group
Conclusion: Sperm motility and morphology abnormality affected fertilization in intracytoplasimic sperm injection. Though value of semen analysis is limited but gives direction to the investigation. Mere semen examination is not at all sufficient to make definitive diagnosis. It is not at all predictive about the functional abilities of the sperms. There is a need for adding an andrology component to the training of the gynecologists