Clinical Results of Intracytoplasmic Sperm Injection in 2146 Consecutive Human IVF Treatment Cycles

Oum, K B; Oh, J H; Sohn, J O; Jung, H M; Ko, J J; Han, S Y; Choi, D H; Yoon, T K; Cha, K Y

Abstract

Since Palermo and coworkers (1992) reported the first ICSI-baby, ICSI has been widely accepted as a treatment of male factor infertility. ICSI techniques have also been used to treat abnormal semen parameters in order to overcome fertilization failures and to increase clinical outcomes. From January 1994 to December 1996, 2146 ICSI cycles were performed at the Infertility Center of Cha General Hospital and we achieved a 75.1% of fertilization rate with 713 subsequent pregnancies (34.8%). The ICSI fertilization rate using 1-day old oocytes which failed to fertilize using conventional IVF method was lower than the ICSI fertilization rate using fresh oocytes (75.7% vs 65.9%). However, we achieved 13 pregnancies out of 125 embryo transfers from the total fertilization failure group. There was no statistical difference in the fertilization rates using normal semen or semen with single defect, but statistical differences were observed between normal semen and semen with two or more defects. No statistical difference was found in pregnancy rates between normal and defective semen groups. In our MESA, PESA and TESE programs, we achieved high fertilization rates (69.2~82.5%) and a 45.8% (mean) pregnancy rate. Categorizing the female patients by age, ie., < or =29, 30~34, 35~39, > or =40, fertilization rates were consistently in the range of 74.5~ 75.7%, but pregnancy rates significantly decreased in patients older than 35 yrs (31.3%) or 40 yrs (14.2%). Of the 713 pregnancies, we were able to obtain follow-up information of the babies in 527 cycles, of which we found 8abnormalities.