Pregnancy outcomes from in-vitro fertilisation and intracytoplasmic sperm injection: a comparison

Rajesh H, Yap HAC, Wu YJ
Correspondence: Dr Hemashree Rajesh, hemashreerajesh@yahoo.com

ABSTRACT
Introduction The purpose of this study was to compare the obstetrical course of in-vitro fertilisation pregnancies with and without intracytoplasmic sperm injection, and to ascertain any difference in the outcome. Both singleton and multiple pregnancies were assessed individually in areas where they could confound results.
Methods This was a retrospective analysis of all successful in-vitro fertilisation pregnancies at the Singapore General Hospital during the period 1998-2003. A total of 271 pregnancies with and without intracytoplasmic sperm injection were evaluated. The details of the pregnancies were obtained from the Assisted Reproductive Technology Registry and Birth Defects Registry.
Results The obstetrical outcome was comparable between the two groups, in terms of the number of deliveries, biochemical and ectopic pregnancies. There was no significant difference in the miscarriage rate. The preterm rates for an intracytoplasmic injection pregnancy were two times higher than that reported in literature for both singletons and multiple pregnancies. The singleton intracytoplasmic sperm injection pregnancies were more likely to deliver preterm (17.5 percent, p-value is 0.041) compared to the ones without intracytoplasmic injection (5.7 percent). The average singleton birth weight was lower for the former (2.94 [+/-0.53] kg) than for the latter (3.19 [+/-0.48] kg, p-value is 0.0173). No definite conclusion could be reached regarding the differences in congenital abnormalities between the two groups.
Conclusion The obstetrical course of an in-vitro fertilisation pregnancy with intracytoplasmic sperm injection pregnancy appears to be similar to one without intracytoplasmic sperm injection except for a slight increase in the preterm deliveries and a lower birth weight at delivery among the singletons.

Keywords: birth weight, intracytoplasmic sperm injection, in-vitro fertilisation, pregnancy outcome, preterm delivery
Singapore Med J 2006; 47(4): 309-314