Comparison of Zygote Intrafallopian Transfer and Intrauterine Embryo Transfer for Male-factor Infertility After Intracytoplasmic Sperm Injection

Objective: In vitro fertilization and embryo transfer (IVF-ET) have been increasingly used for treating male-factor infertility. However, zygote intrafallopian transfer (ZIFT) allows early embryo development to occur within the natural environment of the tubal lumen. The purpose of this study was to analyze whether the mode of embryo transfer, ZIFT versus intrauterine ET, affected the pregnancy outcome in the IVF cycle after intracytoplasmic sperm injection (ICSI) for the treatment of male-factor infertility. Materials and Methods: A total of 140 ICSI procedures (69 ET, 71 ZIFT) were analyzed. A maximum of four cleaving embryos were transferred into the fallopian tube or uterine cavity 48 and 72 hours after oocyte retrieval, respectively. Several variables, including mean age, IVF cycle day 2 hormone levels, peak E2 level, number of oocytes retrieved, number of embryos transferred, endometrial thickness, pulsatility index and resistance index of the uterine artery, and clinical pregnancy rate, were analyzed. Results: The clinical pregnancy rate for ET was 25.4%, versus 24.7% for ZIFT. There was no significant difference between the two groups in the other variables, except for mean age. Conclusion: The data presented in this report demonstrate that there was no therapeutic improvement associated with the increased complexity of ZIFT as compared with intrauterine ET after ICSI for the treatment of male-factor infertility. With the advent of improvements in culture techniques in the IVF laboratory, intrauterine ET remains the technique of choice.