Human Reproduction, Vol 13, 1514-1518, Copyright © 1998 by Oxford University Press
I Govaerts, F Devreker, I Koenig, I Place, M Van den Bergh and Y Englert
The aim of this study was to compare pregnancy characteristics and
perinatal outcome of intracytoplasmic sperm injection (ICSI) pregnancies
with pregnancies obtained after in-vitro fertilization (IVF).
Retrospectively, 145 ICSI pregnancies were matched with 145 IVF pregnancies
using the last menstruation data. The main outcome measures were
preclinical and clinical abortions, ectopic pregnancies, multiple
gestations, prenatal morbidity, prematurity, Caesarean section,
birthweight, perinatal mortality and malformations for singletons, twins
and triplets. Although patients were significantly younger (P < 0.001)
in ICSI (31 years) than in IVF (33 years), their infertility duration (5
years) was similar. The mean number of transferred embryos (2.7 embryos per
transfer) was similar in IVF and ICSI. The rates of preclinical (15%) and
clinical abortions (11% in ICSI versus 15% in IVF) were not different. Four
ectopic pregnancies were observed in the IVF group and none in the ICSI
group. In ICSI, two minor malformations were detected and two therapeutic
abortions were performed respectively for polymalformations and suspicion
of cystic fibrosis. The rate of congenital malformation was 2.8% in ICSI
and 2.2% in IVF. In this last group, one therapeutic abortion for
malformation of neural tube was performed and two minor malformations were
detected. The rate of aborted embryonic sacs before 16 weeks of gestation
was not significantly lower in ICSI compared with IVF (13.7% versus 20%).
The rate of multiple gestations was similar in both groups (31% in IVF and
35% in ICSI). The number of Caesarean sections was similar in IVF and in
ICSI and was twice as frequent for twins versus singletons. The number of
singletons born by Caesarean section was 21% after ICSI and 17% after IVF.
Mean birthweights and gestational ages at birth for twins were
significantly higher (P < 0.05) in ICSI than in IVF (2488 versus 2281 g
and 36.5 versus 35.5 weeks). This difference was not observed for
singletons. In conclusion, pregnancy characteristics and perinatal outcome
after ICSI showed no increase in the number of pathologies in comparison
with IVF.
ARTICLES
Comparison of pregnancy outcome after intracytoplasmic sperm injection and in-vitro fertilization
CUB Erasme Department of Obstetrics and Gynaecology, Fertility Clinic, Free University of Brussels, Belgium.
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