Profiles of embryos designed by fertilization assisted and their impact on the rate of pregnancies

AIM: evaluation of our experience in assisted fertilization by ICSI with analysis of prognostic factors. METHODS: retrospective study of 199 cycles of ICSI during a 2 years and half period between September 2001 and February 2004. The procedure of ICSI included several stages: collection and preparation of the semen, stake in culture of oocytes, removing of cumulus cells and microinjection of oocytes, control of the fertilization and embryo transfer respectively 18 to 22 hours and 48 hours after the microinjection. RESULTS: the mean age of the patients was 32,4 years and the mean duration of infertility was 7 years. The mean fertilization rate was 50%. The mean number of embryos transferred was 2,46. We got 41 pregnancies of which 36 were clinical pregnancies (87,8%). The pregnancy rate was 26,1% by transfer and 21% by retrieval. The women age was the first prognostic factor of ICSI. The pregnancy rate was 27% before the age of 35 years, decreases with age and annul himself after 40 years (P=0,02). The other prognostic factor was the number of 4 cells embryos transferred. The pregnancy rate increases with significant way with the number of 4 cells embryos transferred: 15% after transfer of only one embryo versus 43% after transfer of 3 embryos or more (P=0,04). The ICSI prognostic has not been influenced with significant way by the origin or the sperm mobility, by the duration of infertility and by the total number of embryos transferred. CONCLUSION: the ICSI represents currently the treatment of choice of couple having extreme spermatic changes. The results of our study are comparable to those reported in the literature. The women age and the number of 4 cells embryos transferred are the main factors predicting of the ICSI prognostic.