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Sperm stimulants can improve fertilization rates in male-factor cases undergoing IVF to the same extent as micromanipulation by partial zona dissection (PZD) or subzonal sperm insemination (SUZI): A randomized controlled study



Our purpose was to evaluate the efficacy of direct insemination (IVF), micromanipulation by partial zona dissection (PZD), and subzonal sperm insemination (SUZI) using spermtreated with pentoxifylline (PF) ± 2-deoxyadenosine (2DA).


The overall fertilization rate achieved was similar for all three fertilization techniques (33.1, 30.2, and 26.9% for IVF, SUZI, and PZD, respectively). Patients who had reduced fertilization in previous IVF attempts showed improved fertilization with sperm stimulants, either PF alone or PF in combination with 2DA in standard IVF. In certain cases, SUZI or PZD gave significantly improved fertilization rates in comparison to IVF.


Selective use of sperm stimulants in IVF can achieve fertilization for the majority of male-factor cases. However, PZD and SUZI techniques are useful, especially when sperm stimulants fail to achieve fertilization or achieve poor fertilization in direct insemination.

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Correspondence to W. Rohini Edirisinghe.

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Edirisinghe, W.R., Junk, S., Yovich, J.M. et al. Sperm stimulants can improve fertilization rates in male-factor cases undergoing IVF to the same extent as micromanipulation by partial zona dissection (PZD) or subzonal sperm insemination (SUZI): A randomized controlled study. J Assist Reprod Genet 12, 312–318 (1995). https://doi.org/10.1007/BF02213710

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Key words

  • pentoxifylline
  • 2-deoxyadenosine
  • in vitro fertilization
  • partial zona dissection
  • subzonal sperm insemination