Across Sectional Study of Iraqi Infertile Women to Evaluate ICSI Procedure

Abstract

Implantation remains the least understood key rate-limiting step in assisted reproductive technology (ART). Therefore, the present descriptive cross-sectional study is conducted upon 118 infertile women undergoing intra-cytoplasmic sperm injection (ICSI) in Kamal Al-Samarai Hospital, Center of Fertility and in vitro fertilization (IVF) / Baghdad /Iraq from March 2018 to April 2019, in order to evaluate stimulation step and implantation rate. Intra-cytoplasmic sperm injection was carried out in 138 consecutive treatment cycles of 118 infertile women. The age of patients ranged between 20-45 years, 86 (72.9%) of them are young within age <35 years old, and the rest 32 (27.1%) will be the patients that their age more than or equal 35 years old that abbreviated as old patients. The major cause of infertility in young group was male factor that constitute about 53.5%, while female factors are the main causes of infertility in old patients which constitute about 53.1%. The average number of retrieved oocyte in young patients (10 ± 5.9 oocyte) was significantly (p=0.018) higher than (7.2±4.3 oocyte) obtained from old patients. The frequency of cases with poor ovarian stimulation (POS) in young patients (5.8%) was significantly (p=0.012) lower than 21.9% among old patients. The average number of mature oocytes MII gained from young patients (7.4 ± 4.7) was significantly (p=0.021) higher than obtained from old patients (5.2 ± 3.2). The ooplasm of 823 denuded oocytes was injected with a single spermatozoon , then the average number of embryos obtained after ICSI process in young patients was (4.9 ± 3.4 embryo) significantly (p=0.041) higher than those in old patients (3.5±2.3). Fertilization rate showed non-significant difference between two groups.Only1 patients in old group did not have embryos replaced. The percentage of embryos that have been frozen in young patients (38%) was significantly (p=0.002) higher than (22.8%) in old patients. Out of 118 patients, only 21 women revealed successful implantation which constitutes a rate of 17.7% in this study. In conclusion, the results of these follow-up studies could provide data to allow the safety of the ICSI procedure to be validly assessed on a full scale.