title: Previous fertilization failure with conventional in vitro fertilization is associated with poor outcome of intracytoplasmic sperm injection.
abstract: OBJECTIVE
  To evaluate the outcome of intracytoplasmic sperm injection (ICSI) in patients with a history of fertilization failure with conventional IVF.
  
  
  METHODS
  Retrospective analysis of 2 years of clinical experience with ICSI.
  
  
  METHODS
  Clinical IVF-ET program in a tertiary care referral center.
  
  
  METHODS
  The results of ICSI performed between January 1995 and December 1996 were compared between patients with normal semen parameters and a history of fertilization failure (< 20% of oocytes) with conventional IVF and patients with male factor infertility.
  
  
  METHODS
  In vitro fertilization with ICSI.
  
  
  METHODS
  Parameters examined included oocyte survival, fertilization, embryo cleavage, implantation rates, and clinical pregnancy rates.
  
  
  RESULTS
  Fertilization was achieved with ICSI for all patients during the study period. Although oocyte survival and fertilization did not differ between groups, the pregnancy and implantation rates for patients with a history of idiopathic fertilization failure (20% and 6%, respectively) were significantly lower than those for other patients undergoing ICSI (47% and 22%, respectively).
  
  
  CONCLUSIONS
  The outcome of ICSI varied depending on the indication for treatment. Patients who had a history of failed or poor fertilization in vitro with apparently normal semen parameters had significantly lower pregnancy and implantation rates than did patients with either obstructive azoospermia or impaired semen quality.
authors.affiliation: Department of Gynecology and Obstetrics, Cleveland Clinic Foundation, Ohio 44195, USA.
authors.forename: K F
authors.initials: KF
authors.lastname: Miller
authors.forename: T
authors.initials: T
authors.lastname: Falcone
authors.forename: J M
authors.initials: JM
authors.lastname: Goldberg
authors.forename: M
authors.initials: M
authors.lastname: Attaran
mesh_terms: D000328:Adult; D015331:Cohort Studies; D004624:Embryo Transfer; D005260:Female; D005307:Fertilization in Vitro / Q000379:methods*; D006801:Humans; D007248:Infertility, Male / Q000209:etiology / Q000628:therapy*; D008297:Male; D008845:Microinjections; D011247:Pregnancy; D018873:Pregnancy Rate; D012189:Retrospective Studies; D013084:Sperm-Ovum Interactions; D013094:Spermatozoa / Q000166:cytology*