COMPARISON OF PREGNANCY OUTCOME AFTER INTRACYTOPLASMIC SPERM INJECTION AND IN-VITRO FERTILIZATION

The aim of this study was to compare pregnancy characteristics and per inatal outcome of intracytoplasmic sperm injection (ICSI) pregnancies with pregnancies obtained after in-vitro fertilization (IVF). Retrospe ctively; 145 ICSI pregnancies were matched with 145 IVF pregnancies us ing the last menstruation data. The main outcome measures were preclin ical and clinical abortions, ectopic pregnancies, multiple gestations, prenatal morbidity, prematurity, Caesarean section, birthweight, peri natal mortality and malformations for singletons, twins and triplets, Although patients mere significantly younger (P < 0.001) in ICSI (31 y ears) than in IVF (33 years), their infertility duration (5 years) was similar. The mean number of transferred embryos (2.7 embryos per tran sfer) was similar in IVF and ICSI, The rates of preclinical (15%) and clinical abortions (11% in ICSI versus 15% in IVF) were not different. Four ectopic pregnancies were observed in the IVF group and none in t he ICSI group, In ICSI, two minor malformations were detected and two therapeutic abortions were performed respectively for polymalformation s and suspicion of cystic fibrosis, The rate of congenital malformatio n was 2.8% in ICSI and 2.2% in IVF, In this last group, one therapeuti c abortion for malformation of neural tube was performed and two minor malformations were detected, The rate of aborted embryonic sacs befor e 16 weeks of gestation was not significantly lower in ICSI compared w ith IVF (13.7% versus 20%). The rate of multiple gestations was simila r in both groups (31% in IVF and 35% in ICSI), The number of Caesarean sections was similar in IVF and in ICSI and was twice as frequent for twins versus singletons. The number of singletons born by Caesarean s ection was 21% after ICSI and 17% after IVF. Ill[ean birthweights and gestational ages at birth for twins were significantly higher (P < 0.0 5) in ICSI than in IVF (2488 versus 2281 g and 36.5 versus 35.5 weeks) . This difference was not observed for singletons. In conclusion, preg nancy characteristics and perinatal outcome after ICSI showed no incre ase in the number of pathologies in comparison with IVF.