Cumulative delivery rates after intracytoplasmic sperm injection: 5 year follow-up of 498 patients

The use of life-table analysis for infertility data has the advantages of c larity and ease of application. Success rates per cycle have been reported, but not cumulative delivery rates for intracytoplasmic sperm injection (IC SI), We selected retrospectively 498 Belgian patients <37 years old, who ha d their first ICSI cycle between July 1992 and December 1993, Follow-up was till the end of October 1997, Outcome measure was any delivery >25 weeks. These couples underwent 963 ICSI cycles using fresh ejaculated spermatozoa. The indications for ICSI were long-standing severe male infertility or fer tilization failure after conventional in-vitro fertilization (IVF), Cumulat ive delivery rates were calculated by life-table analysis and compared acco rding to age groups and sperm quality. There were 298 deliveries within a m ean rate per cycle of 31%. The average number of cycles required for a deli very was 3.15 (CI 2.88; 3.43), Twenty-three (4.6%) spontaneous pregnancies occurred after the patients had finished therapy. There was no significant difference between the sperm quality groups but delivery rates decreased si gnificantly with increasing female age, The real delivery rate after six cy cles was 60%, while the expected cumulative delivery rate was 86%. This lif e-table analysis may provide a means by which to counsel couples on the lik elihood of a delivery following ICSI.