PURPOSE To evaluate reproductive outcomes of artificial insemination and IVF with donor sperm (AID or IVF-D) for male-factor couples with a history of unsuccessful ICSI attempt. METHODS This retrospective cohort includes couples with severe male-factor infertility who failed ICSI treatment, and subsequently underwent semen donation treatment. We report the following outcomes: (1) live birth rates in AID and IVF-D treatment for couples with severe male infertility factors and prior ICSI failures; (2) paternal impact on embryo development of the same oocyte cohort; (3) prognostic factors in obtaining a live birth with donor semen. RESULTS Of 92 women with failed ICSI cycles (26 with multiple attempts), 45 couples underwent AID treatment. Live birth rate per cycle of AID was 18.9%. Fifty-three patients underwent IVF-D including 6 couples who previously did not conceive with AID. Embryological outcomes including fertilization, viable cleavage embryos, and blastocyst formation rates were significantly lower in ICSI cycles with partner sperm compared with IVF-D (P < 0.01). Logistic regression analysis showed that female age and the severity of spermatogenetic disorder are prognostic factors in obtaining a live birth with donated sperm. CONCLUSION Couples with severe male infertility factor (azoospermia or extreme oligoasthenospermia) and a history of unsuccessful ICSI cycles benefit from treating with donor sperm. ICSI fertilization, embryo viability, and progression of the embryo to the blastocyst stage are significantly deteriorated by semen parameters. The prognostic factors identified may help couples plan their treatment and prepare for their parenthood journey.

中文翻译：

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胞浆内单精子注射失败后患有严重男性不育症的夫妇的捐献精子的生殖结果。


目的 评估有 ICSI 尝试失败史的男性夫妇人工授精和使用供体精子进行 IVF（AID 或 IVF-D）的生殖结果。方法 该回顾性队列包括患有严重男性不育症、ICSI 治疗失败、随后接受精液捐赠治疗的夫妇。我们报告了以下结果：（1）具有严重男性不育因素且既往 ICSI 失败的夫妇在 AID 和 IVF-D 治疗中的活产率； (2) 父系对同一卵母细胞群胚胎发育的影响； (3) 捐献精液获得活产的预后因素。结果 在 92 名 ICSI 周期失败的女性中（26 名多次尝试），45 对夫妇接受了 AID 治疗。每个 AID 周期的活产率为 18.9%。 53 名患者接受了 IVF-D，其中包括 6 对以前未因 AID 怀孕的夫妇。与 IVF-D 相比，使用伴侣精子的 ICSI 周期中的胚胎学结果（包括受精、可行的卵裂胚胎和囊胚形成率）显着较低（P < 0.01）。 Logistic回归分析显示，女性年龄和生精障碍的严重程度是捐献精子获得活产的预后因素。结论 患有严重男性不育因素（无精子症或极度少弱精子症）且有 ICSI 周期不成功史的夫妇可受益于捐献精子的治疗。精液参数会显着降低 ICSI 受精、胚胎活力以及胚胎向囊胚阶段的进展。确定的预后因素可以帮助夫妇计划他们的治疗并为他们的为人父母之旅做好准备。