Male factor infertility, low fertilisation rate following ICSI and low number of high-quality embryos are associated with high order recurrent implantation failure in young IVF patients.

BACKGROUND: The aim of this study was to characterise the clinical and laboratory parameters in young in vitro fertilisation(IVF) patients with high order recurrent implantation failure (RIF).
METHODS: The first 3 cycles (n = 141 cycles) of 47 consecutive (age <35 years) couples with RIF (> or =6 IVF cycles) were compared with 252 consecutive cycles of 152 couples,treated during the same period, who conceived within the first 3 IVF cycles.
RESULTS: The incidence of male factor infertility or of combined male and female factors was significantly higher in the study group than the control group (male factor: 78.7 versus 42.5%, p= 0.002, OR = 3.2 (95% CI: 1.56.8)). Lower fertilisation rates were noted for the intracytoplasmic sperm injection (ICSI)-treated oocytes of the study group compared with the control group. The availability of high quality embryos for transfer was significantly lower in the RIF group. On multivariate logistic regression analysis, the significantly different variables between the groups were cause of infertility (male factor or combined male and female factors) (p = 0.03),fertilisation rate (p = 0.038), and semen concentration (p = 0.05). CONCLUSIONS; Young IVF patients with high order RIF are characterised by male factor infertility, lower fertilisation rate with ICSI, and fewer high quality embryos available for transfer.