Comparable Reproductive Outcomes of ICSI for Couples with Unexplained Infertility and Couples with Male Factor Infertility

Objective: The aim of this study was to compare intra-Cytoplasmic Sperm Injection (ICSI) outcomes (fertilization rate, embryo quality, pregnancy rate, and live birth rate) for couples with unexplained infertility and couples with male factor infertility, and if the quality of semen is related to ICSI outcomes. Methods: This is a retrospective chart review of 2038 ICSI cycles performed between 2008 and 2014 to compare ICSI outcomes in couples with unexplained infertility and those with male factor infertility. Infertile couples were divided into 6 groups: unexplained infertility (407 patients), mild male factor infertility (not severe) either in isolation (651 patients) or combined (66 patients) with female factor infertility, severe male factor infertility either in isolation (706 patients) or combined (41 patients) with female factor infertility, female infertility in isolation (167 patients). Results: Although, fertilization rates were higher in the unexplained infertility group than in the severe and mild male infertility groups (P <0.05), the number of good-quality embryos and consequently biochemical pregnancy rates were lower than in severe and mild male infertility groups (P <0.05). However, there was no significant difference in the clinical pregnancy rates and live birth rates between the unexplained infertility group and others. Conclusions: This study demonstrates that the use of ICSI for unexplained infertility achieved similar reproductive outcomes as male infertility cases, which are usually referred to ICSI. It also shows that the quality of semen did not positively affect ICSI outcomes. (C) 2018 Middle East Fertility Society. Production and hosting by Elsevier B.V.