Complete failure of fertilization in couples with mechanical infertility: Implications for subsequent in vitro fertilization cycles

Objective: To determine whether complete failure of fertilization of oocytes in couples with mechanical infertility during the first IVF cycle indicates a poor prognosis for subsequent IVF cycles. Design: A retrospective study of 172 cycles of IVF in 50 couples with mechanical infertility and complete failure of fertilization during their first IVF trial. Setting: In vitro fertilization unit of the Sheba Medical Center. Patients: Fifty couples undergoing one to eight cycles of IVF for mechanical infertility. Main Outcome Measure(s): Fertilization rate of retrieved oocytes and pregnancy rate. Results: Of the initial 50 couples, 44 underwent additional IVF cycles, and 43 (97.7%) achieved fertilization during the second or third cycle. Twenty-four patients conceived during the study period as a result of IVF. Conclusions: Complete failure of fertilization in couples with mechanical infertility does not necessarily persist during subsequent IVF cycles. Therefore, at least two more IVF cycles should be attempted before reverting to other therapeutic options. Complete failure of fertilization during the first cycle of IVF in couples with mechanical infertility is accompanied by a good prognosis for subsequent cycles.