A couple's infertility workup reveals: male partner semen analysis — total motility 25%, normal morphology 2% (Kruger strict criteria). The female has patent bilateral tubes and normal ovarian reserve. What is the BEST treatment approach?

• A Intrauterine insemination (IUI) with partner's sperm
• B Intracytoplasmic sperm injection (ICSI) within IVF ✓
• C Clomiphene citrate for the female partner to increase egg numbers for IUI
• D Expectant management for 12 months

Explanation

Severe male factor infertility — total motility <25% AND morphology <4% by Kruger strict criteria — bypasses the indication for IUI (which requires ≥5 million progressively motile sperm after preparation). ICSI (direct injection of a single sperm into each oocyte) achieves fertilisation even with severely abnormal sperm parameters and is the standard of care for severe male factor infertility. IUI with these parameters has very low success rates.

Reference: Shaw's Textbook of Gynaecology, 17th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.