title: Treatment policy after poor fertilization in the first IVF cycle.
abstract: OBJECTIVE
  The chance of recurrence of poor fertilization in a second in vitro fertilization (IVF) cycle was assessed.
  
  
  METHODS
  Total fertilization failure was defined, and the relationship between the fertilization rate and the number of motile sperm cells per milliliter of semen was assessed. Patients with a total fertilization failure or poor fertilization (20% or less of the oocytes fertilized) were divided into three subgroups with different chances of fertilization and were followed in a subsequent IVF cycle.
  
  
  RESULTS
  The recurrence rate of total fertilization failure was high in all three groups (45-70%), and poor fertilization frequently occurred in the second cycle (50-75%).
  
  
  CONCLUSIONS
  Poor fertilization frequently recurs in the second IVF cycle. The use of intracytoplasmic sperm injection could be considered after fertilization of 20% or less of oocytes in the first cycle, irrespective of the number of motile sperm cells per milliliter of semen.
authors.affiliation: Department of Obstetrics and Gynaecology, Zuiderziekenhuis, Rotterdam, The Netherlands.
authors.forename: J
authors.initials: J
authors.lastname: Roest
authors.forename: A M
authors.initials: AM
authors.lastname: Van Heusden
authors.forename: G H
authors.initials: GH
authors.lastname: Zeilmaker
authors.forename: A
authors.initials: A
authors.lastname: Verhoeff
mesh_terms: D005260:Female; D005307:Fertilization in Vitro / Q000706:statistics & numerical data; D006801:Humans; D007246:Infertility / Q000628:therapy; D008297:Male; D008845:Microinjections; D009865:Oocytes / Q000502:physiology; D011247:Pregnancy; D013076:Sperm Count; D017211:Treatment Failure