title: Cumulative pregnancy rate following IVF and intracytoplasmatic sperm injection with ejaculated and testicular spermatozoa.
abstract: The purpose of this study was to calculate the cumulative pregnancy rates of IVF cycles with ICSI using ejaculated or testicular spermatozoa. A computerized database for the IVF cycles with ICSI performed between January 1996 and December 1998 was utilized. Cycles with spermatozoa obtained after electro-ejaculation were excluded. A multifactorial analysis was performed to define the impact of different factors on the success rate of IVF and ICSI. During a 36-month period, 229 pregnancies were achieved by 643 couples using ejaculated spermatozoa, and 83 pregnancies by 167 couples who required testicular spermatozoa. The pregnancy rates (PR) per cycle, including all treatment cycles with ejaculated spermatozoa, remained similar during the first five consecutive cycles achieving a cumulative PR of 80.44%. The cumulative pregnancy rates for cycles with testicular spermatozoa showed a consistent rise during four consecutive treatments and reached 61.84%. The regression analysis of pregnancy rate showed that it was significantly positively correlated with oocyte fertilization rate (P = 0.02), and negatively correlated with maternal age (P = 0.03). Thus, according to the present results, couples with infertility who require IVF with ICSI should be offered at least five consecutive attempts if ejaculated spermatozoa are used, and at least four cycles whenever testicular spermatozoa are used.
authors.affiliation: The IVF Unit, Department of Obstetrics and Gynecology, The Chaim Sheba Medical Centre, Tel Hashomer, (affiliated with Sackler Faculty of Medicine, Tel Aviv University), Israel. adrian@netvision.net.il
authors.forename: Adrian
authors.initials: A
authors.lastname: Shulman
authors.forename: Kfir
authors.initials: K
authors.lastname: Menashe
authors.forename: Arie
authors.initials: A
authors.lastname: Laor
authors.forename: Jacob
authors.initials: J
authors.lastname: Levron
authors.forename: Ygal
authors.initials: Y
authors.lastname: Madgar
authors.forename: David
authors.initials: D
authors.lastname: Bider
authors.forename: Yaron
authors.initials: Y
authors.lastname: Rabinovitz
authors.forename: Daniel
authors.initials: D
authors.lastname: Seidman
authors.forename: Gil
authors.initials: G
authors.lastname: Raviv
authors.forename: Shlomo
authors.initials: S
authors.lastname: Maschiach
authors.forename: Jehoshua
authors.initials: J
authors.lastname: Dor
mesh_terms: D004542:Ejaculation; D005260:Female; D005307:Fertilization in Vitro; D006801:Humans; D008297:Male; D009845:Oligospermia / Q000628:therapy; D011247:Pregnancy; D018873:Pregnancy Rate; D012044:Regression Analysis; D020554:Sperm Injections, Intracytoplasmic; D013737:Testis / Q000166:cytology*; D020858:Tissue and Organ Harvesting / Q000379:methods