ICSI and its outcome

Since its introduction in 1992, intracytoplasmic sperm injection (ICSI) has became a popular assisted fertilization technique proven very efficient in treating male factor infertility, Many healthy children have been born wor ldwide from this procedure, and their physical and mental development appea rs to be within the normal limits. However, because of the peculiarity of t he technique and the poor characteristics of the spermatozoa used, concern about the safety of ICSI still exist. In this article, we analyze the in vi vo development of embryos conceived after ICSI as well as the obstetric out come, occurrence of chromosomal abnormalities, and rate of congenital malfo rmations in neonates born as a result of this treatment. A total of 2435 co uples were studied in whom the male partners were presumed to be the cause of repeated failed attempts at in vitro fertilization (IVF) or had semen pa rameters that were unacceptable for conventional IVF treatment. Pregnancies resulting from 3573 ICSI cycles were analyzed; pregnancy outcome data were obtained from the records of obstetrician-gynecologists and/or pediatricia ns. The overall clinical pregnancy (fetal heartbeat) rate was 44.8% with a resultant delivery rate of 39.2% per ICSI cycle (n = 1388). In 37 of the 77 miscarriages fop which cytogenetic data were available, an autosomal triso my was found in each and 29 additional pregnancies were terminated because of a chromosomal abnormality revealed by prenatal diagnosis. There was an e qual distribution of vaginal deliveries and cesarean sections (n = 682 and n = 658, respectively). Of the 2059 neonates resulting from ICSI treatment, 38 (1.8%) presented with congenital abnormalities (22 major and 16 minor). When the frequency of miscarriages and congenital malformations was analyz ed in terms of semen origin, the outcome was no different between ICSI and IVE The course of pregnancies and occurrence of congenital malformations fo llowing treatment by ICSI are within the ranges obtained following conventi onal IVF.