The postwash total progressively motile sperm cell count is a reliable predictor of total fertilization failure during in vitro fertilization treatment

Objective: To predict the chance of total fertilization failure (TFF) before the day of ovum pickup with known semen and female variables. Design: A statistical model was constructed to predict TFF by retrospective analysis (2,366 couples) and subsequently tested on a new IVF population (917 couples).Setting: Academic tertiary referral center. Patient(s): Three thousand three hundred eighty-three couples who underwent an IVF-ET treatment.Intervention(s): None. Main Outcome Measure(s): The ability to predict the probability of TFF in IVF.Result(s): Two variables-postwash total progressively motile sperm cell count (postwash TPMC) and number of follicles-were found to be significant. Taking a probability of 25% as an acceptable risk of TFF, we calculated that a postwash TPMC of <1.1 × 106 cells results in a risk of TFF of >25%. Low responders (<4 follicles) needed a postwash TPMC of >2.2 × 106 cells to reduce the risk of TFF to <25%. High responders (>15 follicles) needed only 0.35 × 106 postwash progressively motile spermatozoa. Conclusion(s): When postwash TPMC and number of follicles are known and an unacceptable TFF outcome is expected, one can propose an ICSI procedure a few days before the day of ovum pickup. Copyright

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