title: Practical evolution and application of direct intracytoplasmic sperm injection for male factor and idiopathic fertilization failure infertilities.
abstract: OBJECTIVE
  To analyze the introduction of a new assisted fertilization technique for the treatment of severe male factor and idiopathic fertilization failure infertilities.
  
  
  METHODS
  Retrospective analysis of 16-month clinical application of IVF-ET where insemination was performed solely by direct intracytoplasmic sperm injection.
  
  
  METHODS
  Clinical IVF-ET program.
  
  
  METHODS
  Ninety-two couples undergoing 105 cycles of sperm injection.
  
  
  RESULTS
  One hundred embryo transfers yielded 28 viable pregnancies (28%) from which eight normal deliveries have occurred to date. Complete cleavage arrest or fertilization failure occurred in four cycles, and one couple had all embryos cryopreserved. One thousand one hundred forty-three eggs were injected of which 173 (15%) degenerated. Four hundred seventy-nine of the surviving 970 eggs became normally fertilized (49%), and 381 of these zygotes (79.5%) developed suitably for cryopreservation or for transfer. Thirty-four of 310 embryos transferred implanted, yielding an implantation rate of 11%. Both testicular and epididymal sperm were used successfully to achieve fertilization and pregnancies, as was sperm retrieved by electroejaculation. Older women and couples suffering from prior idiopathic fertilization failure had a markedly poorer outcome.
  
  
  CONCLUSIONS
  These results confirm that the intracytoplasmic sperm injection technique is a successful form of assisted fertilization that can be applied to a wide range of couples at significant risk from fertilization failure.
authors.affiliation: Reproductive Biology Associates, Atlanta, Georgia 30342.
authors.forename: M J
authors.initials: MJ
authors.lastname: Tucker
authors.forename: G
authors.initials: G
authors.lastname: Wright
authors.forename: P C
authors.initials: PC
authors.lastname: Morton
authors.forename: M P
authors.initials: MP
authors.lastname: Mayer
authors.forename: P E
authors.initials: PE
authors.lastname: Ingargiola
authors.forename: A E
authors.initials: AE
authors.lastname: Jones
mesh_terms: D000328:Adult; D003593:Cytoplasm; D004624:Embryo Transfer; D005260:Female; D005307:Fertilization in Vitro / Q000379:methods*; D006801:Humans; D007248:Infertility, Male / Q000628:therapy*; D008297:Male; D008845:Microinjections; D011247:Pregnancy; D012189:Retrospective Studies; D013094:Spermatozoa; D017211:Treatment Failure