Intracytoplasmic sperm injection increases embryo fragmentation without affecting clinical outcome

Purpose: To examine the effect of intracytoplasmic sperm injection (ICSI) o n embryo fragmentation and implantation rates in those embryos chosen for t ransfer compared to conventional in vitro fertilization (IVF). Methods: We compared 253 infertility patients (71 ICSI and 182 IVF) with re spect to age, semen analysis, number of embryos transferred embryo fragment ation, implantation rate, and pregnancy rate. Embryo fragmentation was dete rmined by one observer at the same laboratory over the entire study period. Results: A statistically significant difference was observed in mean embryo grade between IVF (2.2 +/- 0.84) and ICSI (2.5 +/- 0.77), P = 0.01. Additi onally, the IVF patients had significantly more nonfragmented (grade I) emb ryos compared to the ICSI group, P < 0.01. Conclusions: These data suggest that ICSI, irrespective of semen parameters , may increase embryo fragmentation and produce fewer nonfragmented grade I embryos while maintaining implantation and pregnancy rates similar to conv entional IVF.