摘要：For years, the management and treatment of male factor infertility has been ‘experience＇ and not ‘evidence＇ based. Although not evidence-based, current clinical practice involves extensive use of assisted reproductive techniques （ART）. Where specific treatments are not indicated or have failed, ART have become popular adjunctive treatments for alleviating male factor infertility. According to the limited evidence available, intrauterine insemination （IUI） may be considered as a first-line treatment in a couple in which the female partner has a normal fertility status and at least 1 × 10^6 progressively motile spermatozoa are recovered after sperm preparation. If no pregnancy is achieved after 3-6 cycles of IUI, optimized in vitro fertilization （IVF） can be proposed. When less than 0.5× 106 progressively motile spermatozoa are obtained after seminal fluid processing or sperm are recovered surgically from the testis or epididymis, intracytoplasmic sperm injection （ICSI） should be performed. Although the outcome of no other ART has ever been scrutinized as much before, no large-scale ‘macroproblems＇ have as yet been observed after ICSI. Yet, ICSI candidates should be rigorously screened before embarking on IVF or ICSI, and thoroughly informed of the limitations of our knowledge on the hereditary aspects of male infertility and the safety aspects of ART.

摘要：Purpose: Can Cortisol Releasing Hormone (CRH) levels in follicular fluid predict outcomes following assisted reproductive treatment (ART) cycles? Methods: Prospective cohort study of 50 women undergoing in vitro fertilisation (IVF)/intra-cytoplasmic sperm injection (ICSI) cycles over a two month study period. All patients were treated on the long stimulation protocol;follicular fluid was aspirated and pooled for each patient. The samples were processed appropriately and assayed using CRH radioimmunoassay (RIA). Results: This study confirmed that CRH was present in follicular fluid. The average level detected was 173 ± 9 pg/mL (mean ± standard error of mean [SEM]). The data suggests a positive correlation of CRH follicular fluid levels greater than 145 pg/mL with successful ART outcomes. Conclusion: The data indicates a positive correlation between ART outcomes and the presence of follicular fluid CRH levels greater than 145 pg/mL. The results should be interpreted with caution due to the small sample size and pooling of follicular fluid per patient. Furthermore, the pooling of follicular fluid is not representative of CRH levels in an individual follicle, and thus, mature oocyte. This study serves as a reminder to what has previously been hypothesised.