title: Clinical and economic analysis of rescue intracytoplasmic sperm injection cycles.
abstract: OBJECTIVE
  To identify clinical and embryological factors that may predict success in rescue intracytoplasmic sperm injection (ICSI) cycles (after total fertilization failure has occurred) and to evaluate the cost effectiveness of rescue ICSI strategy. Additionally, follow-up of 20 rescue ICSI pregnancies is reported.
  
  
  METHODS
  Retrospective analysis of total fertilization failure cycles.
  
  
  METHODS
  University-based tertiary medical center.
  
  
  METHODS
  In total, 92 patients who had undergone conventional in-vitro fertilization (IVF) cycles with total fertilization failure were included. The patients were divided into two subgroups: those who conceived through rescue ICSI and those who did not.
  
  
  RESULTS
  The pregnant members of the rescue ICSI subgroup were found to be significantly younger (32.9 ± 4.2 vs. 36.3 ± 4.5, respectively, p = 0.0035,) and to have better-quality embryos than those who did not conceive (cumulative embryo score: 38.3 ± 20.4 vs. 29.3 ± 14.7, p = 0.025). Cost effectiveness analysis showed 25% reduction in the cost per live birth when rescue ICSI is compared to cycle cancellation approach. The pregnancies follow-up did not show adverse perinatal outcome.
  
  
  CONCLUSIONS
  Rescue ICSI is an option for salvaging IVF cycles complicated by total fertilization failure. Success in rescue ICSI was found to be associated with younger age and higher quality of embryos. Furthermore, the cost effectiveness of rescue ICSI in terms of total fertilization failure was found to be worthwhile.
authors: Department of Obstetrics and Gynecology, McGill University, Montreal, Quebec, Canada. 100paz@walla.com
authors: Einat
authors: E
authors: Shalom-paz
authors: Jana
authors: J
authors: Alshalati
authors: Fady
authors: F
authors: Shehata
authors: Luis
authors: L
authors: Jimenez
authors: Weon-Young
authors: WY
authors: Son
authors: Hananel
authors: H
authors: Holzer
authors: Seang Lin
authors: SL
authors: Tan
authors: Benny
authors: B
authors: Almog
mesh_terms: D000328:Adult; D003362:Cost-Benefit Analysis; D003365:Costs and Cost Analysis; D005260:Female; D006801:Humans; D007246:Infertility / Q000191:economics / Q000628:therapy*; D008297:Male; D011247:Pregnancy; D011256:Pregnancy Outcome; D018873:Pregnancy Rate; D012189:Retrospective Studies; D055502:Secondary Prevention; D020554:Sperm Injections, Intracytoplasmic / Q000191:economics*; D017211:Treatment Failure; D016896:Treatment Outcome