Use of early rescue intracytoplasmic sperm injection and subsequent intracytoplasmic sperm injection in patients with previous fertilization failure or low fertilization rate after conventional IVF.

Objective To evaluate the clinical outcomes of the combination of short-period fertilization with early rescue intracytoplasmic sperm injection(R-ICSI) in patients after complete fertilization failure and low fertilization rate in conventional in vitro fertilization(IVF) procedures and to analyze the clinical outcomes of ICSI in those patients.Methods A retrospective study was carried out from the Center of Reproductive Medicine of the Second Hospital of Hebei Medical University between January 2011 and December 2011,including cycles of R-ICSI(Group A),cycles of conventional IVF and ICSI in one cycle(Half-ICSI)(Group B),ICSI cycles(Group C) following a previous fertilization failure and low fertilization rate in conventional IVF,and direct ICSI cycles(group D) at the same period were performed.The clinical outcomes and laboratory parameters were compared in Group A,B,D and in Group C,D were analyzed.Results(1) The implantation rates and pregnancy rates in group A showed significant differences from those in group B[(17.02% vs.32.41%) and(25.00% vs.46.15%),respectively,P 0.05].The percentage of diploid zygotes and percentage of embryos can be utilized in group B showed significant differences from those in group D[(74.97% vs.88.50%) and(32.33% vs.40.31%),respectively,P0.05].(2) The percentage of embryo frozen cycles and implantation rates in group C showed significant differences from those in group D[(32.26% vs.53.03%) and(13.92% vs.33.03%),respectively,P 0.05].The abortion rates in group C was higher than that of group D and the percentage of diploid zygotes,pregnancy rates were lower than those of group D,but there were no significant differences.Conclusions(1) The combination of short-period fertilization with early R-ICSI combined Half-ICSI can find and rescue complete fertilization failure and low fertilization rate in conventional IVF procedures timely,and get better clinical effect.(2) ICSI may be a good choice to owercome previous fertilization failure,but the implantation rate is lower.It suggests it may be due at least partly to oocyte abnormality,which results in the descent of embryo development potential.