Total fertilization failure in intracytoplasmic sperm injection: a retrospective comparative study

Purpose: The aim of this study was to evaluate total fertilization failure (TFF), embryo transfers following TFF cycles, and recurrent TFF, and to define the factors that might cause TFF. Materials and Methods: Cycles that resulted in TFF (group 1, n=109), embryo transfers after TFF cycles (group 2, n=30), and cases of recurrent TFF (group 3, n=15) were evaluated retrospectively. Results: Peak estradiol was higher in group 2 than other groups, and the rate of sperm morphology below 4% was lower in group 2 when compared to groups 1 and 3. The total numbers of retrieved oocytes (5.3 +/- 4.1 vs 10.2 +/- 1.5 (Odds Ratio=1.639; 95% CI 1.267-2.122)) and MII oocytes (2.9 +/- 2.2 vs 6.8 +/- 1.8 (Odds Ratio=2.218; 95% CI 1.529-3.216)) were significantly higher in embryo transfer cycles when compared to previous TFF cycles. Retrieved and MII oocytes counts were higher in group 2 with a median fertilization rate of 46.42% when compared to groups 1 and 3. Conclusion: With more retrieved and MII oocytes, normal sperm morphology can increase the fertilization rate of ICSI cycles following earlier TFF.