Factors predicting the outcome of intracytoplasmic sperm injection for infertility.

ABSTRACT

BACKGROUND: Male factor abnormality is the cause of infertility in about 20%-40% of infertile couples. Assisted reproduction with intracytoplasmic sperm injection is the only treatment option for severe forms of andrological infertility. METHODS: We retrospectively analysed patients who had had intracytoplasmic sperm injection for male factor infertility. The clinical and laboratory factors that influenced the pregnancy rate were also analysed. RESULTS: One hundred and seventy-five cycles in 164 couples were analysed. The fertilization, cleavage and pregnancy rates were similar in the groups that had had intracytoplasmic sperm injection with epididymal, testicular or ejaculate sperm. Univariate analysis of the clinical variables showed progressive reduction in pregnancy rate with increase in the woman partner's age and body mass index, and presence of pelvic disease, but these were not statistically significant. The age of the woman was the most significant factor affecting the pregnancy rate after adjusting for body mass index and pelvic disease in the multivariate analysis (OR 0.26, 95% CI 0.08-0.84, p=0.03). The oocyte number, embryo transfer number and transfer day had no significant influence on the outcome. CONCLUSION: The woman partner's age influences the success of assisted reproduction with intracytoplasmic sperm injection in male factor infertility. Thus, the chances of success are better if the couple seeks treatment at an early age.