Predictors of intracytoplasmic sperm injection (ICSI) outcome in couples with and without male factor infertility.

ABSTRACT

AIM: To find out the predictors of ICSI outcome. METHODS: Forty-three pregnancies in 100 consecutive ICSI cycles. RESULTS: Every 1,000 pg/ml increase in hCG-day E2 (OR = 0.46, CI 0.25-0.83, p = 0.01) and 1% decrease in the rate of normal sperm morphology (OR = 0.81, CI 0.67-0.98, p = 0.03) caused a significant decrease in clinical pregnancy rate and live birth rate (respectively, OR = 0.5, CI 0.32-0.96, p = 0.03, OR = 0.66, CI 0.5-0.86, p = 0.002) while every increase in the number of good quality embryos transferred caused a two-time increase in the clinical pregnancy rate (OR = 2.1, CI 1.2-4, p = 0.01). On the other hand, every increase in the number of four-cell cleavage embryos (OR = 1.02, CI 1.002-1.04, p = 0.03) and hCG-day endometrial thickness (OR = 1.6, CI 1.15-2.24, p = 0.005) were found to increase the live birth rate. Implantation rate (m = 8.3 +/- 14.6) was significantly lower in cases with leucocytospermia (n = 33) compared to cases without leucocytospermia (n = 67, m = 17.4 +/- 24.6, p = 0.02). CONCLUSION: Leucocytospermia, hCG-day E2 level and endometrial thickness, normal sperm morphology, and number of good quality embryos are predictors of implantation, clinical pregnancy and live birth rate following ICSI.