Predictors of Intra Cytoplasmic Sperm Injection Success in Couples With Unexplained Sub-Fertility

Abstract

Objective: About 10-15% of sub-fertility cases facing the clinicians in the reproductive clinics remains unexplained. Opinions regarding the optimal treatment plan for them exhibit a wide differences among fertility specialists. This study aims to assess the outcome of ICSI and predictors success in couples with unexplained sub-fertility. Methods: Sixty six sub-fertile couples with unexplained infertility were included. ICSI was done for all. They divided into 2 groups pregnant and non-pregnant. They were followed up retrospectively to evaluate the predictors of ICSI treatment success and results were compared between them. Results: Chemical pregnancy was rate 42.2%. Pregnant females were significantly : younger with a mean age of 26.7±4.2 vs 28.6±3.6, lower BMI of 27.6± 4.9 vs 30.2± 4.9, lower cycle day 2 LH level 2.3 ±0.99 vs 2.9±0.94 and had a slightly thinner endometirum 3.3± 0.68 vs 3.9 ±1.1 than non-pregnant ones. Females of both groups exhibited no significant difference regarding the response to controlled ovarian stimulation, the mean total number of retrieved and mature oocytes were comparable, the only exception is the mean total number of immature oocytes which was significantly lower in the pregnant females 0.85± 1.1 vs 30.2± 4.9 in non-pregnant with no significant difference regarding fertilization rate, total number of embryos, cleavage rate and embryos’ quality. Conclusion: Intra cytoplasmic sperm injection has the ability, within certain limits, to bypass the obstacles of natural pregnancy failure in couples with unexplained sub-fertility and should be considered for those couples as early as possible before female partner get older.