title: Complete failed fertilization after intracytoplasmic sperm injection--analysis of 10 years' data.
abstract: OBJECTIVE
  To investigate incidence and causes of complete failed fertilization after intracytoplasmic sperm injection (ICSI) in a tertiary care facility.
  
  
  METHODS
  A total of 1,779 cycles between February 1994 and December 2003 were analyzed. Study parameters were female age, infertility diagnosis, ovarian stimulation protocol, estradiol level on day of hCG administration, number of follicles, number of oocytes retrieved, number of oocytes injected, and semen parameters.
  
  
  RESULTS
  Complete failed fertilization occurred in 23 cycles (1.29%) involving a total of 85 oocytes injected. Infertility causes among patients with failed fertilization included unexplained (43.6%), male factor (26%), presence of more than one factor (17.4%), hysterectomy (4.4%), premature ovarian failure (4.3%), and advanced age (4.3%). In 12 cycles (52%), fewer than 5 follicles were present. In three (13%) cycles, no mature (MII) oocyte was available and in 61% (14/23) fewer than 3 MII oocytes were available for ICSI. Immotile sperm was used for ICSI in 5 cycles (21.7%). The source of sperm in 17 (74%) cycles was from ejaculate, in 4 cycles from testicular aspiration (TESA), one from percutaneous epididymal sperm aspiration (PESA) and one from retrograde ejaculation.
  
  
  CONCLUSIONS
  Our data indicate that major contributing factors to failed fertilization after intracytoplasmic sperm injection are number of MII oocytes retrieved and availability of viable sperm for injection. Although the incidence of complete failed fertilization is not remarkable, it may increase with increasing patient age and a lower number of follicles.
authors.affiliation: IVF Clinical and Research Laboratory, Toronto Centre for Advanced Reproductive Technology (TCART), Toronto, ON, Canada. nesfand@excite.com
authors.forename: Navid
authors.initials: N
authors.lastname: Esfandiari
authors.forename: Murid H
authors.initials: MH
authors.lastname: Javed
authors.forename: Lynda
authors.initials: L
authors.lastname: Gotlieb
authors.forename: Robert F
authors.initials: RF
authors.lastname: Casper
mesh_terms: D000328:Adult; D005260:Female; D005307:Fertilization in Vitro / Q000706:statistics & numerical data; D006801:Humans; D007247:Infertility, Female / Q000628:therapy*; D008845:Microinjections; D019836:Preimplantation Diagnosis / Q000706:statistics & numerical data; D012189:Retrospective Studies; D020554:Sperm Injections, Intracytoplasmic / Q000706:statistics & numerical data*; D017211:Treatment Failure