Control Group (N = 10):

c o n e C o u n t

vol (cc) (106/cc) ( × 106) % motile

pre post

2.8 ± 0.3 22.8 ± 7.2 57.1 + 14.3 49.4 ± 2.9 2.8 _+ 0.4 26.5 _+ 10.4 62.2 ± 27.5 53.2 ± 3.2

imGC % normal % tapered (×106)

pre 10.1 ± 2.0 19.7 _+ 2.2 0.8 _+ 0.2 post 10.5 ± 1.9 19.3 ± 2.2 0.3 ± 0.2

Study Group (N = 8):

cone count vol (cc) (106/cc) ( × 106) % motile

pre 2.7 ± 0.5 14.9 _+ 7.0 42.0 ± 8.9 52.5 ± 4.1 post 3.9 ± 0.6 47.9 ± 14.2" 158.1 ± 33.0* 53.9 ± 3.3

imGC % normal % tapered (×106)

pre 14.0 ± 2.8 21.4 + 4.8 1.7 -+ 0.5 post 16.8 + 3.1 16.8 ± 3.1 0.9 -+ 0.2

*p < 0.05.

Conclusions: Nut r i t iona l evaluat ion and supplementa- t ion is an impor tan t adjunct in the overall evaluat ion and t r ea tmen t of the subfertile male. The marked improve- men t in total count demonstra ted after 3 months of nut r i - t ional supplementa t ion for dietary deficiencies suggests tha t dietary factors significantly affect spermatogenesis.

P-041

Predictive Factors for the Outcome of Intrauterine Insemination (IUI). C. Keck, C. Gerber-Sch~ffer, M. Breckwoldt. Dept of OB/GYN, Univers i ty of Freiburg, Ger- many.

Objective: To evaluate if conventional semen parame- ters predict the outcome of IUI t rea tment .

Design: Retrospective analysis of 414 IUI cycles, com- par ing semen parameters from IUI cycles in which a preg- nancy was achieved with cycles in which no pregnancy was achieved.

Pa t ients and methods: In this s tudy the resul ts of 414 consecutive IUI cycles which have been performed for 124 couples (3.3 cycles per couple; range: 1 -6 ) were analyzed. Mean female age was 32.8 yrs (22-45), mean male age was 35.7 yrs (24-54). Mean durat ion of infert i l i ty was 22 months (10-144). For ovulation induct ion clomifen citrate was applied in 381 cycles, hMG was used in 24 cycles and 9 IUI were performed in spontaneous cycles. For sperm preparat ion the swim-up technique was used in 313 cycles whereas Percoll centr ifugation was performed in 101 cy- cles.

Results: 35 pregnancies were achieved (8.4% per cycle; 28.2% per couple). 31 pregnancies occured in the 1st to 4th t r ea tmen t cycle (88%) whereas 4 pregnancies were achieved in the 5th or 6th cycle (12%). There were no significant differences between mean semen parameters

of pat ients for whom a pregnancy could be achieved and pat ients without pregnancy (M _+ SEM): sperm concentra- tion: 24.8 _+ 7.3 mill/ml vs 22.5 +_ 13.1 mill/ml); progressive motility: 39.5 + 14.2% vs 41 _+ 8.7%; normal sperm mor- phology: 21.6 ± 6.0% vs 23.4 _ 7.4%. After Percoll centrifu- gation sperm concentrat ion was significantly higher com- pared with swim-up preparat ion (23.9 + 11.6 mill/ml vs 10.4 _+ 6.3 mill/ml) whereas progressive motili ty was higher after swim-up (88.3 _+ 11% vs 56.4 _+ 17.4%). Preg- nancy rates in both groups were s imilar (9.3% vs 6.1%).

Conclusion: Even in the era of IVF/ICSI t rea tment , IUI may be considered for t r ea tmen t of mild to moderate male factor infertility. As most of the pregnancies are achieved wi th in 1 - 4 t r ea tmen t cycles, not more t han 4 cycles should be performed. On the basis of conventional semen parame- ters the outcome of IUI t r ea tmen t can not be predicted accurately.

P-042

ICSI Using Cryo-Thawed Surgically Retrieved and Ejaculated Spermatozoa Versus Fresh Samples. A. Kamal, I. Fahmy, R. Mansour, M. Aboulghar, N.A. Ta- wab. The Egypt ian IVF-ET Center, Maadi, Cairo, Egypt.

Objective: The min ima l sperm requ i rement to achieve high ferti l ization rate (FR) and pregnancy rate (PR) with intracytoplasmic sperm injection opened the possibility of cryopreserving surgically retrieved spermatozoa for future use, specially when it is difficult to have fresh samples or to avoid a new surgical procedure. The objective of this s tudy was to compare the results of ICSI us ing cryo- thawed spermatozoa (surgically retrieved and ejaculated) to the results when fresh spermatozoa were used.

Design: Retrospective analysis of ICSI outcome us ing cryo-thawed versus fresh spermatozoa is cases of obstruc- tive azoospermia and severe oligospermia.

Materials and Methods: Group A: Cryo-thawed sperm from 34 pat ients were analysed including test icular sperm N=8; epididymal sperm N = 4 from cases with obstructive azoospermia, and ejaculated sperm N-22 from cases with severe oligospermia. Group B: Fresh sperm from 221 pa- t ients, tes t icular N=85, epididymal N-40 from cases with obstructive azoospermia and ejaculated N=96 form cases with severe oligospermia. The FR, and PR were compared between the two groups.

Results: All pa t ients had successful ferti l ization and reached embryo t ransfer stage. The FR and PR in group A were 56.3% and 33.3% respectively when surgically re- tr ieved cryo-thawed spermatozoa were used and 59.1% and 22.7% when cryo-thawed ejaculated spermatozoa were used. In group B the FR, and PR were 55.8%, 31.2% when surgically retrieved fresh spermatozoa were used and 61.8% and 27.1% when fresh spermatozoa were used. There was no statist ical significant difference between cryopreserved and fresh sperm in both groups.

Conclusions: The use of cryo-thawed spermatozoa whether surgically retrieved in obstructive azoospermia or ejaculated in cases of severe oligospermia for ICSI gives a comparable resul ts to fresh samples and offers a valu- able therapeut ic option specially for azoospermia pat ients

$112 Abstracts