FACTORS AFFECTING SUCCESS WITH INTRACYTOPLASMIC SPERM INJECTION

In this study, 141 couples underwent 163 cycles of in vitro fertilizat ion (IVF) and embryo transfer in which the eggs were inseminated by in tracytoplasmic sperm injection (ICSI). Overall, 41% of the injected eg gs were normally fertilized and 81% of the resulting embryos were suit able for cryopreservation (91 embryos) or uterine transfer. From 153 f lesh embryo transfers, 45 ongoing or delivered pregnancies (27.6% per cycle) were achieved, and of the 507 embryos transferred, 54 successfu lly implanted giving an implantation rate per embryo of 10.7%. Five ad ditional pregnancies did not yield a viable fetus or underwent a spont aneous abortion, giving a miscarriage rate of 10% (5/50). Increased ma ternal age or a prior diagnosis of failed fertilization after conventi onal IVF had a significantly negative impact on success. Sperm from th e testis and epididymis, those retrieved by electro-ejaculation, and c ompletely immotile ejaculated sperm all gave rise to pregnancies. ICSI reinsemination was used with limited success to rescue failed fertili zation cycles, although the implantation rate per embryo was poor (5%) . ICSI has greatly improved the ability to use IVF for treating couple s with a poor fertilization potential.