Prognosis for clinical pregnancy and delivery after total fertilization failure during conventional in vitro fertilization or intracytoplasmic sperm injection

Objective: To determine the prognosis for clinical pregnancy and delivery after total fertilization failure. Design: Retrospective analysis of patient treatment cycles. Setting: Private fertility clinic. Patient(s): 555 couples who had total fertilization failure during a cycle of conventional in vitro fertilization OVF) or intracytoplasmic sperm injection (1CSI). Intervention(S): None. Main Outcome Measure(S): Delivery rates, peak estradiol level, number of mature follicles, number of oocytes retrieved, number of mature oocytes, sperm concentration, and sperm motility. Result(s): Delivery rates for lVF patients who elected to continue treatment after fertilization failure were 44% per patient, 25% per embryo transfer (ET), and 22% per cycle. Delivery rates for ICSI patients were 36% per patient, 23% per ET, and 18% per cycle. The number of mature oocytes was always statistically significantly lower in the total fertilization failure cycle when compared with fertilization cycles that occurred either before or after, whether ICSI or conventional IVF was involved. Conclusion(S): The prognosis for pregnancy is encouraging in subsequent cycles after total fertilization failure. Fertilization failure was a result of suboptimal response to ovarian stimulation.