Subsequent therapeutic options and outcome in couples who fail to fertilize despite in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI).

PURPOSE: Failed fertilization with ICSI in women having at least five mature oocytes retrieved is uncommon. The present study evaluated 19 such patients to determine--based on this outcome--what option they would choose next and what the outcome would be.

METHODS

The study requirements included females age < or = 43 and use of ejaculated sperm.

RESULTS

Five of 19 women (26.3%) had severe oligoasthenozoospermia. Options chosen were 1) donor egg (n = 3), 2) donor embryo (n = 1), 3) donor sperm (n = 1), 4) treatment cessation (n = 3), 5) resuming IVF-ET and ICSI (n = 11). Live deliveries occurred in 1) (n = 2), 2) (n = 1), and 5) (n = 4).

CONCLUSIONS

When faced with failed fertilization with ICSI a small majority of women (11/19, 57.9%) chose to still try with their own gametes and some succeeded (36.3%). These data may be helpful in counseling couples who fail fertilization despite IVF with ICSI in making a decision as to their next therapeutic choice.