Analysis of Unsuccessful Embryo Transfers in 2146 Consecutive ICSI Cycles

Sohn, J O; Oum, K B; Lee, J H; Kim, H J; Yoon, T K; Cha, K Y

Abstract

Since the introduction of intracytoplasmic sperm injection [ICSI] by Palermo et al.[1992], ICSI has been widely accepted in many IVF programs, including our own. Since our first successful pregnancy in 1993 using ICSI, we have continued to utilize the method in our IVF program to treat male factor patients. From January 1994 to December 1996, 2146 ICSI cycles were performed, most of the cases involving patients with severe male-factor infertility. The overall fertilization rate from the 2146 cycles was 76.0%. Embryo transfers failed in only 93 cycles[4.3%]. Details of the 93 failed ET`s were analysed. The fertilization rate of the ET failure group was 15.4% and the rates of 1PN and 3PN formation were 1.3% and 5.9%, respectively. A significant difference was found in the 3PN formation rate of the successful ET cycles [1.1%] compared with the 3PN rate of the failed embryo transfer group. The fertilization rate of small number[< or =3] of oocyte group was slightly lower than the groups of oocyte number 4~7 and more than 8. Forty eight cycles out of 93[51.6%] were categorized as having a poor quality oocyte with severe granulation, degenerative signs or abnormal morphology. In 24 cycles where non-motile sperm were used, fertilization did not occur. The women`s ages were not correlated with the fertilization rates. In conclusion, ET failures following ICSI for the treatment of severe male factor infertility was mainly caused by poor quality oocytes and/or poor viability of the spermatozoa used for injection into oocytes.