Prospective controlled randomized study of in vitro fertilization versus intracytoplasmic sperm injection in the treatment of tubal factor in fertility with normal semen parameters

Objective: To compare the results of IVF and intracytoplasmic sperm injection (ICSI) in tubal factor infertility with normal semen parameters. Design: A prospective randomized study. Setting: The Egyptian IVF-ET Center. Participants: One hundred sixteen patients infertile due to tubal factor were divided randomly into two groups. Group A (n = 58) was treated with IVF and group B (n = 58) was treated with ICSI. Intervention: In vitro fertilization and ICSI. Main Outcome Measure: Pregnancy rate. Results: In group A, 736 oocytes were retrieved and normal (two pronuclear [2pN]) fertilization occurred in 477 oocytes (64.8%). In group B, 748 oocytes were retrieved, 572 metaphase II oocytes were injected, and 2PN fertilization occurred in 400 oocytes (70% per injected oocyte and 53.5% per retrieved oocyte). Clinical pregnancy was diagnosed in 18 patients in group A (31%) and 19 patients in group B (32.8%). There was no significant difference in the pregnancy rate between the two groups. The fertilization rate per retrieved oocytes was significantly higher in group A. Conclusions: Intracytoplasmic sperm injection does not offer a higher pregnancy rate as compared with IVF in the treatment of tubal factor infertility with normal semen.