title: Analysis of 232 total fertilization failure cycles during intracytoplasmic sperm injection.
abstract: BACKGROUND
  The intracytoplasmic sperm injection procedure ending with total fertilization failure is very distressfull event for both the clinician and the patient.
  
  
  OBJECTIVE
  The aim of this study was to identify independent factors which could be used to identify total fertilization failure before the day of intracytoplasmic sperm injection.
  
  
  METHODS
  This was a retrospective study of 232 patients who were admitted to a tertiary-care hospital IVF Unit and showed total fertilization failure during intracytoplasmic sperm injection cycles. To sort out the interwined effects of female age, basal FSH, sperm quality, antral follicle count, starting dose of gonadotrophine, sperm extraction technique, cycle length, >14 mm follicle number, oocyte number after oocyte pick up, estradiol and progesterone level on the day of hCG and the MI, MII and GV oocyte number on the fertilization, multiple logistic regression analysis was used.
  
  
  RESULTS
  The total fertilization failure rate was 6% and the recurrance rate was 23%. The original model illustrated that the presence of GV oocytes, total oocyte number less than six, <2000 pg/mL E2 concentration on the day of hCG and testicular sperm extraction increases the total fertilization failure risk.
  
  
  CONCLUSIONS
  It is very difficult to predict total fertilization failure. Sometimes even with one good quality oocyte and sperm and in the case of globozoospermia fertilization can be achieved. Not only azoospermia but also low oocyte numbers increase the chance of total fertilization failure even after intracytoplasmic sperm injection.
authors.affiliation: Centre for Reproductive Medicine, Zekai Tahir Burak Women's Health Research and Education Hospital, Ankara, Turkey.
authors.forename: Esma
authors.initials: E
authors.lastname: Sarikaya
authors.affiliation: Centre for Reproductive Medicine, Zekai Tahir Burak Women's Health Research and Education Hospital, Ankara, Turkey.
authors.forename: Ozlem Gun
authors.initials: OG
authors.lastname: Eryilmaz
authors.affiliation: Centre for Reproductive Medicine, Zekai Tahir Burak Women's Health Research and Education Hospital, Ankara, Turkey.
authors.forename: Ruya
authors.initials: R
authors.lastname: Deveer
authors.affiliation: Centre for Reproductive Medicine, Zekai Tahir Burak Women's Health Research and Education Hospital, Ankara, Turkey.
authors.forename: Muammer
authors.initials: M
authors.lastname: Dogan
authors.affiliation: Centre for Reproductive Medicine, Zekai Tahir Burak Women's Health Research and Education Hospital, Ankara, Turkey.
authors.forename: Leyla
authors.initials: L
authors.lastname: Mollamahmutoglu
keywords: Cyclecharasteristics; ICSI; Total fertilization failure