PREVIOUS FERTILIZATION FAILURE WITH CONVENTIONAL IN-VITRO FERTILIZATION IS ASSOCIATED WITH POOR OUTCOME OF INTRACYTOPLASMIC SPERM INJECTION

Objective: To evaluate the outcome of intracytoplasmic sperm injection (ICSI) in patients with a history of fertilization failure with conve ntional IVF. Design: Retrospective analysis of 2 years of clinical exp erience with ICSI. Setting: Clinical IVF-ET program in a tertiary care referral center. Patient(s): The results of ICSI performed between Ja nuary 1995 and December 1996 were compared between patients with norma l semen parameters and a history of fertilization failure (<20% of ooc ytes) with conventional IVF and patients with male factor infertility. Intervention(s): In vitro fertilization with ICSI. Main Outcome Measu re(s): Parameters examined included oocyte survival, fertilization, em bryo cleavage, implantation rates, and clinical pregnancy rates. Resul t(s): Fertilization was achieved with ICSI for all patients during the study period. Although oocyte survival and fertilization did not diff er between groups, the pregnancy and implantation rates for patients w ith a history of idiopathic fertilization failure (20% and 6%, respect ively) were significantly lower than those for other patients undergoi ng ICSI (47% and 22%, respectively). Conclusion(s): The outcome of ICS I varied depending on the indication for treatment. Patients who had a history of failed or poor fertilization in vitro with apparently norm al semen parameters had significantly lower pregnancy and implantation rates than did patients with either obstructive azoospermia or impair ed semen quality. (C) 1998 by American Society for Reproductive Medici ne.