Morphology and clinical outcomes of embryos after in vitro fertilization are superior to those after intracytoplasmic sperm injection

Objective: To compare embryos obtained after IVF and intracytoplasmic sperm injection (ICSI) regarding morphology and the likelihood of achieving clinical pregnancy. Design: Case-control study. Setting: An IVF unit controlling 1,310 cycles in 1996. Patient(s): Women having a total of 477 IVF and 475 ICSI consecutive cycles. Intervention(s): Ovarian stimulation, IVF- ET, or ICSI-ET for all couples. Main Outcome Measure(s): Number of grade-A embryos transferred, preclinical pregnancy losses, and clinical pregnancy rates in IVF and ICSI cycles. Result(s): In comparison with the ICSI group, the IVF group showed significantly more grade-A embryos available for transfer (mean, 2 ± 1.6 versus 1.8 ± 1.5), significantly fewer preclinical pregnancy losses (1.6% versus 4%), and significantly higher clinical pregnancy rates (25% versus 19.1%). Conclusion(s): Embryos obtained after IVF are superior to those obtained after ICSI in relation to embryo morphology and the likelihood of achieving clinical pregnancy.