Intracytoplasmic sperm injection versus in vitro fertilization for patients with a tubal factor as their sole cause of infertility: a prospective, randomized trial

Objective: To compare the efficacy of intracytoplasmic sperm injection and IVF in women with a tuboperitoneal factor as their sole cause of infertilit y. Design: Prospective, randomized study. Setting: Hacettepe University Assisted Reproduction Unit, Ankara, Turkey. Patient(s): Seventy-six consecutively seen patients with tuboperitoneal fac tor infertility were randomized on an alternate basis to undergo either int racytoplasmic sperm injection (38 patients and cycles) or IVF (38 patients and cycles). Intervention(s): Intracytoplasmic sperm injection and IVF. Main Outcome Measure(s): Fertilization, implantation, and clinical pregnanc y rates. Result(s): A comparable number of oocytes and embryos were obtained with in tracytoplasmic sperm injection and IVF. The two-pronuclei fertilization rat es per metaphase IT oocyte or mature cumulus-oocyte complex were similar in the two groups. The numbers of total and grade I embryos transferred also were similar. Comparisons of intracytoplasmic sperm injection and IVF did n ot reveal any statistically significant differences in individual implantat ion rates (38.75% +/- 24.46% and 34.58% +/- 16.97%, respectively) clinical pregnancy rates per cycle (21.05% and 21.05%, respectively), or take-home i nfant rates (18.42% and 15.79%, respectively). The type of procedure perfor med was not a significant predictor of clinical pregnancy. Conclusion(s): When a decision is made to proceed with an assisted reproduc tive technique in patients with a tubal factor as their sole cause of infer tility, IVF should be the initial treatment of choice. (C) 1999 by American Society for Reproductive Medicine.