National study of factors influencing assisted reproductive technology (ART) outcomes with male factor infertility

Department of Urology, University of Kansas Medical Center, Kansas City, Kansas 66160, USA.
Fertility and sterility (Impact Factor: 4.59). 07/2011; 96(3):609-14. DOI: 10.1016/j.fertnstert.2011.06.026
Source: PubMed


To evaluate the outcomes of assisted reproductive technology (ART) cycles for male factor infertility, and method of sperm collection.
Historic cohort study.
Clinic-based data.
Cycles from the Society for Assisted Reproductive Technology Clinic Outcomes Reporting System database for 2004 to 2008 were limited to three groups: non-intracytoplasmic sperm injection (ICSI) and ICSI cycles for tubal ligation only; non-ICSI and ICSI cycles for male factor infertility only; and all cycles (regardless of infertility diagnosis) using ICSI only. INTERVENTION(S) AND MAIN OUTCOME MEASURE(S): Multivariate logistic regression was used to model the adjusted odds ratio (AOR) of clinical intrauterine gestation (CIG) and live birth (LB) rates for tubal ligation versus male factor infertility only; ICSI versus non-ICSI for male factor infertility only; and ICSI outcomes based on method of sperm collection.
Models for male factor infertility only versus tubal ligation only ICSI cycles had lower CIG (AOR 0.92) but not LB (AOR 0.87). No difference was seen for non-ICSI cycles. Within male factor infertility only cycles, ICSI had a worse outcome than non-ICSI for CIG (AOR 0.93) but not for LB (AOR 0.94). For all ICSI cycles with no male factor infertility and ejaculated sperm as the reference group, models showed better rates of CIG with male factor infertility ejaculated sperm (AOR 1.07) and with male factor infertility aspirated sperm (AOR 1.09). The LB rate was higher with male factor infertility ejaculated sperm only (AOR 1.04).
The ICSI and sperm source influence CIG and LB rates in male factor infertility cases.

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Available from: Ajay K Nangia, Mar 17, 2014
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    • "Evidently, those patients who had ICSI without a male factor could be negatively biased in terms of their prognosis, beyond what could be accounted for in multivariable models including patient and clinical characteristics (Boulet et al., 2015). While no dataset is perfect, it is important to note that the results are consistent with the prior large database analyses reported by Jain & Gupta (2007) and Nangia et al. (2011). The Practice Committees of the American Society of Reproductive Medicine and the Society for Assisted Reproductive Technology reached similar conclusions and state in their guidelines that the data do not support the use of ICSI for advanced maternal age, low oocyte yield or unexplained infertility (Practice Committees of the American Society for Reproductive Medicine & Society for Assisted Reproductive Technology, 2012). "

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