Impact of fertilization history and semen parameters on ICSI outcome.
OBJECTIVE
The objectives of this study were (1) to investigate intracytoplasmic sperm injection (ICSI) outcome according to its indications, i.e., a history of failed or poor fertilization and unsuitable sperm parameters for conventional IVF, and (2) to examine the impact of a female's age, sperm concentration, motility, morphology, presence of antisperm antibodies, and hemizona assay (HZA) results on overall outcome.


METHODS
Two hundred seventy-nine ICSI cycles performed in 207 couples were retrospectively evaluated.


RESULTS
Clinical pregnancy and delivery rates were 36.8 and 29.8% for patients with prior failed fertilization, 23.2 and 17.8% for patients who had prior poor fertilization, and 28.6 and 21.3% for patients with unsuitable sperm parameters. The differences among all groups were found to be insignificant. There was a significant, negative correlation between a female's age and pregnancy results. No difference was found in the three basic sperm parameters between those patients who produced and those who did not produce a pregnancy, but the fertilization rate was significantly higher in patients with more adequate sperm parameters. Although there was a trend toward a better fertilization rate in patients with a hemizona index (HZI) greater than 30 (indicative of a superior sperm-zona pellucida binding capacity) than in those with a HZI less than 30, the difference was not significant. There were no differences in fertilization rate according to the presence or absence of antisperm antibodies.


CONCLUSIONS
Fertilization history in a conventional IVF cycle has no effect on success rates following ICSI, and there is no correlation among the basic sperm parameters, the presence of antisperm antibodies, and pregnancy rates.
Mercan
R
R
Howard and Georgeama Jones Institute for Women's Health, Department of Obstetrics and Gynecology, Eastern Virginia Medical School, Norfolk 23507, USA.
Oehninger
S
S
Muasher
S J
SJ
Toner
J P
JP
Mayer
J
J
Lanzendorf
S E
SE
D000367:Age Factors; D000906:Antibodies / Q000494:pharmacology; D005260:Female; D005306:Fertilization / Q000502:physiology; D005307:Fertilization in Vitro; D006801:Humans; D008297:Male; D017063:Outcome Assessment, Health Care; D011247:Pregnancy; D011256:Pregnancy Outcome; D012189:Retrospective Studies; D012661:Semen / Q000502:physiology*; D013076:Sperm Count; D013094:Spermatozoa / Q000276:immunology / Q000502:physiology; D016896:Treatment Outcome; D015044:Zona Pellucida / Q000502:physiology
D000906:Antibodies