Impacto das tecnicas de reprodução assistida no tratamento da infertilidade masculina

AUTOR(ES)
DATA DE PUBLICAÇÃO

1995

RESUMO

From 1990 to 1 994, 331 male patients with primary infertility were treated at the Department of Urology of the University of Campinas Medical School - UNICAMP. The initial approach included conventional medical and surgical (varicocelectomy) regimens. Patients who did not achieve pregnancy with these modalities underwent assisted reproduction therapy. The conventional treatment group included 258 patients treated medically (clomiphene citrate, 50 mg qd, or chorionic human gonadotropin, 2000 UI/week, assodated with human menopausa I gonadotropin, 1000 UI/week, administered for 12 months). A total of 4 patients achieved pregnancy (1,55%). Surgical Aof total 73 patients underwent (varicocelectomy) nd medical treatment and were followed for 18 months. Pregnancy was achieved in 10 patients (13,70%). The pregnancy rate for conventional treatment was 4.23%. A total of 317 patients did not achieve pregnancy with conventional treatment. Of these, 63 were submitted to assisted reproduction. Intrauterine insemination (AIH) was selected when initial capacitation could recover at least 2 million motile sperms (grades A and B). A total of 36 patients (57,14%) received 1 to 9 cycles of AIH, totalizing 131 cycles. Pregnancy was observed in 14 patients (38.89%) with a pregnancy rate of 10.69% per cycle. There was not statistically significant difference when the results were compared according to the number of spermatozoa inseminated (2 to 5 and 5 to 10 million sperms). In vitro fertilization (IVF) was used when the initial capacitation could recover less than 2 million motile sperms. A total of 27 patients (42.86%) were treated with 37 cycles of IVF and 3 (11.11 %) achieved pregnancy (pregnancy rate per cycle of 8.11 %). There was not statistically significant difference when the results were compared according to the number of spermatozoa used for the in vitro fertilization (1 to 2 millions or lower than 1 million motile sperm). The total pregnancy rate for assisted reproduction was 26.98%. In conclusion, assisted reproduction is the treatment of choice for mal e patients with primary infertility, with or without varicocele, in view of its higher efficacy rate compared to conventional treatment.

ASSUNTO(S)

terapeutica fertilização in vitro infecundidade masculina inseminação artificial

ACESSO AO ARTIGO

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