Predictors for Number of Retrieved Oocytes in Intracytoplasmic Sperm Injection

Abstract

Background: Successful ICSI depends on ovarian response to stimulation and maturation of oocytes retrieved. Objective: To identify predictors of number of retrieved oocytes during intra cytoplasmic sperm injection(ICSI). Methods: A cross sectional study carried out at Islamabad Clinic Serving Infertile Couples @ Saudi Pak Tower from January 2011 till December 2012. Female subjects (n= 282) aged 20 -40 years had base line estimation of follicle stimulating hormone, estradiol, antral follicle count and ovarian volume on the second day of cycle. Down regulation of ovaries was followed by controlled ovarian stimulation for 12 ± 2days. On the day of ovulation induction by intramuscular injection of human chorionic gonadotropin, preovulatory follicle count (PFC) was measured by trans vaginal scan and serum estradiol, progesterone and interleukin I-β were estimated. Data was expressed as mean ± standard deviation and median with interquartile range. Correlation coefficient was measured to study degree of association of demographic and clinical factors with NRO. Univariate regression of NRO as dependent variable with predictors was confirmed by multivariate regression. Results: Retrieved oocytes had strongest correlation with PFC (r = 0.98). Multivariable analysis stipulated that in the presence of other variables PFC had similar strongest effect on oocytes. AFC showed significant but negative effect on NRO by multiple regressions. Progesterone, E2, IL-I β, FSH and injections used for stimulation had insignificant effect in the presence of other variables. Conclusion: PFC measured at the time of ovulation induction is strongest predictor of oocytes which are obtained during oocyte pick up procedure of ICSI. Key Words: Intracytoplasmic Sperm Injection, Pre-ovulatory Follicle Count, Ovarian Reserve, Antral Follicle Count, Controlled Ovarian Stimulation.