Intracytoplasmic sperm injection (ICSI): the Brussels experience

Area of Science:

• Reproductive Medicine
• Andrology
• Embryology

Background:

• Male factor infertility and previous failed conventional in vitro fertilization (IVF) cycles present significant challenges.
• Excretory azoospermia necessitates advanced sperm retrieval techniques for assisted reproduction.

Purpose of the Study:

• To evaluate the efficacy and outcomes of intracytoplasmic sperm injection (ICSI) in couples with specific infertility factors.
• To report on clinical pregnancy rates, live birth rates, and congenital anomaly incidence following ICSI.

Main Methods:

• Analysis of 1275 consecutive ICSI cycles over 26 months in 919 couples.
• Inclusion criteria: male factor infertility, prior failed IVF, or severe semen abnormalities requiring sperm retrieval (microsurgical epididymal sperm aspiration or testicular sperm retrieval).

Main Results:

• Achieved a 2-pronuclear (PN) fertilization rate of 47.7% per retrieved oocyte and 66.4% per injected oocyte.
• Clinical pregnancy rate was 28.4% per started cycle and 31.3% per embryo transfer.
• 416 children born, with 16 major congenital malformations (3.9%), not indicating increased concern.

Conclusions:

• ICSI demonstrates a successful approach for couples with severe male factor infertility and recurrent IVF failure.
• The observed rate of major congenital anomalies in ICSI-born children is not significantly different from general population rates.
• ICSI provides a valuable microassisted fertilization option with favorable pregnancy and birth outcomes.