An evaluation of the efficacy of in vitro fertilization with intracytoplasmic sperm injection for sperm with low hypoosmotic swelling test scores and poor morphology.

PURPOSE: To corroborate or refute a previous study demonstrating that in vitro fertilization (IVF) with intracytoplasmic sperm injection (ICSI) is an effective therapy for infertility related to males with subnormal hypoosmotic swelling tests (HOST). The study would also determine if the copresence of poor morphology has any adverse effect on outcome.
METHODS: Clinical and viable pregnancy rates and implantation rates were evaluated in a second series of patients. The data were further stratified according to whether the semen specimen demonstrated morphology using strict criteria < 4% normal vs > or = 4%.
RESULTS: Clinical and viable pregnancy rates and implantation rates were 49.1, 45.3, and 23.4% for those with subnormal HOST scores and subnormal morphology vs 38.0, 34.3, and 22.5% for those with low HOST and strict morphology > or = 4% (p = NS, chi-square analysis).
CONCLUSIONS: In vitro fertilization with ICSI is an effective therapy for infertility related to subnormal HOST scores. Poor morphology does not adversely affect the outcome.