REINSEMINATION BY INTRACYTOPLASMIC SPERM INJECTION OF 1-DAY-OLD OOCYTES AFTER COMPLETE CONVENTIONAL FERTILIZATION FAILURE

Objective: To analyze the efficacy of intracytoplasmic sperm injection (ICSI) for ''rescue'' of failed conventional insemination cycles. Des ign: Retrospective clinical study. Setting: Private infertility clinic . Patient(s): Fifty-four couples with non-male factor infertility unde rgoing routine IVF within our clinic. Intervention(s): Twenty-to ad-ho ur-old unfertilized mature oocytes from conventional IVF cycles in whi ch fertilization failure was complete were reinseminated by ICSI to at tempt late fertilization and rescue of the otherwise failed IVF cycle. Main Outcome Measure(s): Late fertilization, pregnancy, and embryonic implantation. Result(s): Intracytoplasmic sperm injection reinseminat ion of 489 unfertilized mature oocytes caused degeneration in 50 (10.2 %) oocytes, gave rise to normal fertilization in 215 (44.0%) of the in jected oocytes, and allowed ET in 48 of the 54; cycles in which initia l complete fertilization failure had occurred. One hundred sixty-four (76.3%) of 215 late-fertilized oocytes either were used for fresh tran sfer or were frozen-stored. Eight viable pregnancies resulted, yieldin g a 14.8% pregnancy rate per initiated cycle. Conclusion(s): Barring p otential concerns regarding the chromosomal normality of embryos arisi ng from reinsemination, our results suggest that ICSI is a relatively successful means of rescuing conventional IVF cycles in which fertiliz ation fails completely. (C) 1997 by American Society for Reproductive Medicine.