Received March 02, 1997
Accepted May 17, 1997

Introduction: The male factor can be treated with assisted reproduction techniques, i. e., artificial insemination with husband's sperm (AIHS), "in vitro " fertilization (IVF), and intracytoplasmic sperm injection (ICSI). Material and Methods: The men included in the study presented oligoasthenozoospermia according to WHO (1992) criteria in lhe sperm sample colected on the day of the procedure. A total of 126 AIHS procedures were carried out in cycles stimulated with gonadotropins. One insemination per cycle was then performed 36 to 38 hours after administration of human chorionic gonadotropin. A total of 152 standard IVF cycles and 303 ICSI cycles were performed. For ICSI the cumulus-corona complex was removed and spermatozoa were injected under an Olympus IMT-2 microscope equipped with Hoffman contrast and coupled to an automatic MM-88 manipulator (Narishige, Japan). MO-202 hydraulic manipulators (Narishige, Japan) were used to control the injection micropipettes and oocyte fixation. A solution of 10% polyvinylpyrrolidone was used to immobilize the spermatozoa. When possible, the spermatozoa were washed on a Percoll gradient (40%, 90%). Results: The pregnancy rate per cycle was 7.9% for AlHS, 16.4% for IVF and 31.3% for ICSI. The results demonstrate the superiority of ICSI over AIHS (p<0.01) and over standard IVF (p<0.01). Conclusion: ICSI is the assisted reproduction technique of choice for the treatment of oligoasthenozoospermia when only the efficiency ofthe method is considered.