Andrologische Einflußfaktoren der In-vitro-Fertilisation

The purpose of the study was to identify semen parameters relevant for in vitro fertilization (IVF). A total of 151 ejaculates from 130 patients were analyzed. There was a significant association between successful IVF, high sperm concentration and good sperm motility. Progressive sperm motility correlated best with successful fertilization of oocytes (r=+0.427) and was the only parameter significantly linked to pregnancy. Very low values were sufficient for fertilization in vitro: a sperm concentration of 4.5×106/ml and a progressive sperm motility of 20%. The results of analysis of fructose, citrate and neutral α-glucosidase as markers of seminal vesicle, prostate and epididymal functions were not different in fertilizing and non-fertilizing semen samples. Moderate increases in granulocyte elastase levels, between 250 and 1000 ng/ml, did not influence IVF. However, two patients with genital tract inflammation (PMN-elastase >1000 ng/ml) did not fertilize despite excellent semen parameters. These results stress the importance of andrological factors for in vitro fertilization outcome.