Comparison of pregnancy outcome after intracytoplasmic sperm injection and in-vitro fertilization

The aim of this study was to compare pregnancy characteristics andperinatal outcome of intracytoplasmic sperm injection (ICSI) pregnancieswith pregnancies obtained after in-vitro fertilization (IVF).Retrospectively, 145 ICSI pregnancies were matched with 145 IVF pregnanciesusing the last menstruation data. The main outcome measures werepreclinical and clinical abortions, ectopic pregnancies, multiplegestations, prenatal morbidity, prematurity, Caesarean section,birthweight, perinatal mortality and malformations for singletons, twinsand triplets. Although patients were significantly younger (P < 0.001)in ICSI (31 years) than in IVF (33 years), their infertility duration (5years) was similar. The mean number of transferred embryos (2.7 embryos pertransfer) was similar in IVF and ICSI. The rates of preclinical (15%) andclinical abortions (11% in ICSI versus 15% in IVF) were not different. Fourectopic pregnancies were observed in the IVF group and none in the ICSIgroup. In ICSI, two minor malformations were detected and two therapeuticabortions were performed respectively for polymalformations and suspicionof cystic fibrosis. The rate of congenital malformation was 2.8% in ICSIand 2.2% in IVF. In this last group, one therapeutic abortion formalformation of neural tube was performed and two minor malformations weredetected. The rate of aborted embryonic sacs before 16 weeks of gestationwas 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 and35% in ICSI). The number of Caesarean sections was similar in IVF and inICSI and was twice as frequent for twins versus singletons. The number ofsingletons born by Caesarean section was 21% after ICSI and 17% after IVF.Mean birthweights and gestational ages at birth for twins weresignificantly higher (P < 0.05) in ICSI than in IVF (2488 versus 2281 gand 36.5 versus 35.5 weeks). This difference was not observed forsingletons. In conclusion, pregnancy characteristics and perinatal outcomeafter ICSI showed no increase in the number of pathologies in comparisonwith IVF.