COMPARISONS OF PREGNANCY LOSS PATTERNS AFTER INTRACYTOPLASMIC SPERM INJECTION AND OTHER ASSISTED REPRODUCTIVE TECHNOLOGIES

Objective: To compare outcome of pregnancies after intracytoplasmic sp erm injection (ICSI) with those of other assisted reproductive technol ogies. Design: Pregnancy outcomes after ICSI were followed prospective ly and compared with pregnancy outcomes after IVF with fresh and froze n ETs and donor oocyte cycles. Setting: A private tertiary referral ce nter for genetics and infertility in Fairfax, Virginia. Patients: One hundred thirty-six couples achieving pregnancy after undergoing ICSI, 71 after IVF, 35 donor oocyte recipients, and 19 after transfer of fro zen-thawed embryos. Interventions: In vitro fertilization and/or ET fo r all couples. Dilatation and curettage to obtain products of concepti on for chromosome analysis in 28 women experiencing spontaneous aborti on. Main Outcome Measures: Pregnancy outcomes were classified as precl inical loss, clinical loss, and ongoing pregnancy. Results: The mean f requency of preclinical pregnancy loss was 26% after ICSI, 28% after I VF, 3% after ET using donor oocytes, and 11% after frozen ET. The rate of clinical loss after ICSI (21%) was compared with IVF (18%), donor oocyte cycles (11%), and frozen ETs (21%). Conclusions: Intracytoplasm ic sperm injection is not associated with an increase in pregnancy los ses, clinical or preclinical, compared with conventional IVF.