Evidence that oligoasthenozoospermia may be an etiologic factor for spontaneous abortion after in vitro fertilization-embryo transfer

Objective: To evaluate whether oligoasthenozoospermia may lead to a higher spontaneous abortion (SAB) rate once a pregnancy is established by IVF-ET. Design: Retrospective clinical observational study. Setting: University-based IVF program. Patient(s): Three hundred sixty-four couples with normal semen parameters who underwent IVF-ET with conventional sperm incubation; 70 couples with oligoasthenozoospermia but without marked abnormal sperm morphology (<4% normal forms using strict criteria) who underwent ET after IVF with conventional sperm incubation; and 20 couples with oligoasthenozoospermia but without abnormal sperm morphology who underwent ET after IVF with intracytoplasmic sperm injection (ICSI). Main Outcome Measure(s): Implantation rate, clinical pregnancy rate, SAB rate, and delivery rate after IVF-ET. Result(s): Despite similar pregnancy and implantation rates per ET, as a result of a higher SAB rate (40.0% versus 11.7%), the delivery rates were lower in the female partners of men with oligoasthenozoospermia. Similar patients who used ICSI had a 0% SAB rate. Conclusion(s): Oligoasthenozoospermia should be considered a possible risk factor for SAB in IVF achieved pregnancies. Further studies are needed to determine whether ICSI reduces the risk of SAB associated with oligoasthenozoospermia. (C) 1997 by American Society for Reproductive Medicine.