Is intracytoplasmic sperm injection (ICSI) a safe procedure? What do we learn from early pregnancy data about ICSI?

The aim of this study was to evaluate the safety of the intracytoplasmic sperm injection (ICSI) procedure by analysing early pregnancy data from ICSI and in-vitro fertilization (IVF) patients. In all, 50 ICSI pregnancies were compared with 226 IVF pregnancies. Comparisons were made during the first 9 weeks after the theoretical last menstrual period (7 weeks after oocyte retrieval) with regard to epidemiological data, plasma hormonal concentrations and transvaginal ultrasonographical findings. Although patients were significantly (P < 0.001) younger in ICSI (31 years) than in IVF pregnancies (33 years), their duration of infertility was similar. Miscarriage and multiple gestation rates were not significantly different in ICSI pregnancies (respectively 24 and 24%) from those found after IVF (32 and 29%). The probability of developmental arrest of the intrauterine sac (miscarriages and vanishing twins) was similar in both ICSI (16%) and IVF (25%) cases. The mean plasma hormonal concentrations starting from day 11 after oocyte retrieval were similar in both groups. Every ICSI and IVF pregnancy showed an embryo with cardiac activity at 7 weeks. Early pregnancy data did not show any abnormal findings for pregnancies achieved using ICSI compared to those achieved by IVF.