Introduction ICSI is routinely used in ART and in male factor (MF) infertility treatment is the only feasible option.
Although we know that ICSI can achieve high fertilization, pregnancy and implantation rates bypassing any type ofabnormal semen parameter, specific data about obstetric and perinatal risks of this practice is still lacking. For this reason, we decided to evaluate ICSI clinical outcomes in couples with male factor infertility and to compare with a control group. Objective: to evaluate ICSI outcomes in couples with male factor infertility compared with a control group presenting tubal factor diagnosis Method: a retrospective observational study was carried out in the IVF Unit of the University Clinical Hospital “José de San Martín” between January 2013 and December 2016. All couples with male factor (MF) according to WHO 2010 5th edition or tubal factor (TF) infertility undergoing ICSI treatment that have realized fresh embryo transfers (FET) and got pregnant were included in the study. The effect of MF infertility on laboratory and clinical outcomes compared with the control group was evaluated with Wilcoxon (Mann- Whitney) test and Odds Ratio. Continuous variables were analyzed using t-Student. The α considered was 5% and statistical analysis was performed using a free Software InfoStat 2016I. The results are expressed as means ± standard deviation (SD). Results: from a total of 619 FET, 153 got pregnant (25, 2 %) and only 71 were couples with MF infertility and 19 were diagnosed with TF and considered as the control group. No differences between groups were found in average age, number of oocytes retrieved or fertilized and number of embryos transferred (35, 34 ± 4, 21 and 35, 38 ± 4, 48; 8, 20 ±4, 74 and 8, 62±5, 10; 4, 82 ± 2, 94 and 5, 38 ± 3, 74; 2, 11 ± 0, 60 and 2, 07 ± 0, 59 respectively for MF and TF group; p: NS). Miscarriage rate was similar in both groups (Odds Ratio 0, 62; Li: 0, 35 and Ls: 2, 82, p= 0, 3138). Differences in gestational age and weight of newborns were not statistically significant between MF and control group (37, 74±1, 64 vs 37, 29±2, 28 weeks with p value= 0, 6152 and 3370, 29± 530, 49 grs; Li: 3185, 20 and Ls: 3555, 39 vs 3277, 94± 445, 34 grs; Li: 3048, 97 and Ls: 3506, 91; CI 95% with p value= 0, 3219 for MF and control groups respectively). Preterm birth (< 37 weeks) showed no significant differences between groups (11, 8% vs 29, 4% for MF and TF, Odds Ratio: 3, 12; Li: 0, 71 and Ls: 13, 6 with p value= 0, 1228). Conclusion: obstetric and perinatal outcomes in patients with male factor diagnosis do not differ from a control group indicating that ICSI is a safe technique that overcomes infertility associated with any type of male factor without affecting livebirth.