[Intracytoplasmic sperm injection (ICSI) after previous failure of heterologous insemination]

We report on our experiences with 25 married couples that approached us for intracytoplasmatic sperm injection (ICSI) after previous failure of artificial insemination by donor (AID). AID has been carried out in several specialized fertility centers. We traditionally refrain from donor semen procedures. All patients have undergone at least 4 treatment cycles of AID, the maximum was 20. With exception of one all patients have been inseminated after ovarian hyperstimulation according to different protocols (e.g. GnRH-A/FSH, hMG; CC/hMG). Prior to ICSI we have confirmed male subfertility being in all patients of severe grade. All patients have been proven to have ejaculated spermatozoa. We have performed 71 treatment cycles for ICSI so far, 19 patients have become pregnant, 3 have aborted. The pregnancy rate per cycle is 26%, per embryo transfer 30%, and per patient 76%. We think that these results are primarily caused by so far unknown defects in oocytes and their function during fertilization. Besides, we assume psychosomatic causes maybe involved.