Benefit of intracytoplasmic sperm injection in patients with a high incidence of triploidy in a prior in vitro fertilization cycle.
OBJECTIVE
To test the hypothesis that intracytoplasmic sperm injection (ICSI) overcomes a high incidence of tripronucleate zygotes resulting from standard insemination in a previous cycle.


METHODS
A retrospective analysis of matched-pair cycles.


METHODS
Assisted reproductive technologies (ART) program of Brigham and Women's Hospital.


METHODS
Ninety-five patients with a > or = 20% incidence of tripronucleate zygotes in an IVF cycle with use of ICSI in a subsequent attempt.


METHODS
Cycles with either standard insemination or ICSI.


METHODS
Incidence of diploid (2pn) and triploid (3pn) zygotes and number and quality of embryos obtained.


RESULTS
Patient age, ampules of gonadotropin used, peak E2, number of follicles at hCG trigger, and total number of oocytes were all significantly higher in the ICSI cycles, but the number of mature oocytes did not differ. After ICSI, the percentage of 2pn was higher (65.0% vs. 34.1%) and the percentage of 3pn was lower (5.0% vs. 33.9%) than after IVF, and more diploid embryos were obtained with ICSI (5.5 +/- 3.7 vs. 3.4 +/- 2.2 [mean +/- SD]). There was no difference in embryo quality between the two groups.


CONCLUSIONS
ICSI appears beneficial in women with a high 3pn occurrence from IVF because it increases the number of diploid zygotes without affecting embryo quality.
Jun
Sunny H
SH
Department of Obstetrics and Gynecology, Stanford University Medical Center, Stanford, California, USA.
O'Leary
Thomas
T
Jackson
Katharine V
KV
Racowsky
Catherine
C
D000328:Adult; D005260:Female; D005307:Fertilization in Vitro / Q000706:statistics & numerical data*; D006801:Humans; D015994:Incidence; D007248:Infertility, Male / Q000453:epidemiology* / Q000628:therapy*; D008297:Male; D011123:Polyploidy; D011247:Pregnancy; D011256:Pregnancy Outcome / Q000453:epidemiology*; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D020554:Sperm Injections, Intracytoplasmic / Q000706:statistics & numerical data*; D017211:Treatment Failure; D014481:United States / Q000453:epidemiology