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Abstract

Objective: The aim of this study was to compare assisted reproduction outcome of couples with male factor and unexplained infertility.
Methodology: This study is ten years of retrospective chart review of 1913 ICSI cycles performed at ART unit of a tertiary center between 2014―2023. Patients who underwent IVF due to the diagnosis of male factor infertility were included in study group (n=560). Those with unexplained infertility were added as controls (n=1353). Groups were compared in terms of cycle outcome.
Results: Female age revealed significantly higher in control group (32.2 vs 31.0,p<0.001), while no significant difference was observed between the groups among male. While higher number of Grade-1 embryos were utilized in male factor group on 2nd day, top-quality and good-quality blastocyst utilization were higher in control group. Sperm concentration and total sperm motility were significantly lower in male factor group (p<0.05), whereas mean ejaculate volume was similar. A significantly higher rate of pregnancy was observed in male factor group (36.4% vs 40.1%) while cycle cancellation was higher in the controls (p<0.001). Multivariate regression analysis revealed that positive pregnancy was significantly associated with total sperm motility and concentration after adjustment for male and female age (p<0.05). Sperm concentration was significantly associated with utilization of top-quality blastocycts (p<0.05).
Conclusions: Intrastoplasmic sperm injection provided worse results in progession from clevage stage to blastocycst formation in cases with male factor infertility. Analysis revealed that pregnancy outcome was significantly associated with total sperm motility. Sperm concentration was significantly associated with number of day five top-quality embryos.