Advantages of treatment with human follicular fluid in the management of severely dyspermic patients in human in vitro fertilization programs.

Abstract

In 26 couples undergoing in-vitro fertilization and embryo transfer (IVF/ET), where the male partner was severely dyspermic, the seminal fluid was treated with Pellet Swim-up (PSu), modified by a 20-minute sperm incubation period in non-decomplemented human follicular fluid (hFF) diluted to 50%. In another group of 26 severely dyspermic couples undergoing IVF/ET, the semen was treated with a variant of centrifugation on discontinuous Percoll gradients (CDPG), called mini-CDPG. Pre-treatment with hFF produced a significant increase in oocyte fertilization rate (46.8% in the hFF group compared with 18.4% in the mini-CDPG couples; Kolmogorov-Smirnov Test: D = 0.5, p < 0.01), in the transfer rate per patient (96.1% in the hFF group and 50% in the mini-CDPG group; (Chi-square Test: x2 = 11.827, p < 0.001), and in the pregnancy rate per patient (respectively of 26.9% and 0%; Fisher's exact probability test: P = 0.0049, p < 0.01). There was a high miscarriage rate in the pregnancies obtained in the hFF group (42.8%). The results might be linked to a positive effect of the hFF on sperm capacity and on acrosome reaction. The Authors conclude that the use of hFF would seem to be an extremely useful treatment of the semen of severely dyspermic patients in assisted fertilization programs.