KAOUTAR BEN MAKHLOUF

Morocco

Impact of Clinical and Biological Factors on Intra-Cytoplasmic Sperm Injection (ICSI) Success Rates: A Retrospective Analysis of 478 Infertile Couples

Kaoutar BEN MAKHLOUF 1, 2, Yousra BENMAKHLOUF 1, Najib BOUDRA 2, Yasmina SERGHINI 2, Naima GHAILANI NOUROUTI 1, Amina BARAKAT 1, Mohcine BENNANI MECHITA 1

1 Department of Biology, Intelligent Automation & BioMed Genomics Laboratory, Abdelmalek Essaâdi University, Faculty of Sciences and Technology, Tangier, Morocco
2 BFC-Fez Assisted Reproductive Medicine Center, Fez, Morocco

Abstract

Background

Infertility affects a significant proportion of couples worldwide, and Intra-Cytoplasmic Sperm Injection (ICSI) has become one of the most widely used assisted reproductive technologies (ART) for treating male and female infertility. Between January 2019 and October 2024, a total of 711 ICSI cycles were performed at the Boudra Fertility Center (BFC) in Fez, Morocco. This retrospective study aims to identify and analyze the clinical and biological factors influencing ICSI outcomes, including patient age, oocyte and embryo quality, and underlying causes of infertility.
The primary objective of this study is to evaluate the impact of these factors on the rate of ongoing pregnancies. Additionally, we aim to explore the major causes of infertility within our patient population and investigate their association with treatment success. The findings from this study are expected to provide valuable insights into optimizing treatment protocols and improving the overall success rates of ICSI at our center.

Methods

This retrospective study, conducted at the Boudra Fertility Center in Fez, Morocco, from January 2019 to October 2024, included 478 infertile couples who underwent a total of 711 ICSI cycles. Couples with women aged 18 to 45 years were included, and those with incomplete data or who abandoned treatment were excluded. Data were collected from medical records, including demographic information, infertility diagnoses, causes (male, female, or idiopathic), surgical history, oocyte and embryo quality, and clinical outcomes (clinical and ongoing pregnancy rates).
All patients underwent ovarian stimulation, ovulation triggering, oocyte retrieval, and embryo transfer based on embryo quality. Statistical analyses were performed using SPSS and R software, with chi-square tests and t-tests to evaluate associations between clinical and biological factors and ICSI outcomes, and logistic regression to identify predictors of ongoing pregnancy.

Results

A total of 478 infertile couples underwent 711 ICSI cycles at the Boudra Fertility Center between January 2019 and October 2024. The female participants had an average age of 33.3 years, with a median age of 34 years. The most common causes of infertility included male factor infertility, female factor infertility (such as Polycystic Ovary Syndrome (PCOS), ovulatory disorders, tubal issues, and endometriosis), mixed infertility, and idiopathic infertility.
The clinical pregnancy rate for ICSI cycles was significant, with a notable difference based on the age of the women. Younger women generally had higher pregnancy success rates compared to older women. Oocyte quality, as determined by the number of mature oocytes, played a key role in the fertilization process, and the quality of embryos was also a major factor influencing success rates. Factors such as patient age, oocyte and embryo quality were identified as important predictors of ICSI success.

Conclusions

This study identifies key factors influencing ICSI outcomes at the Boudra Fertility Center, including patient age, oocyte quality, and embryo quality. Younger women had higher pregnancy success rates, and both oocyte and embryo quality were significant predictors of success. These findings emphasize the importance of optimizing treatment protocols based on age and infertility causes. The results can help improve ICSI success rates and guide future clinical practices in assisted reproduction. Further research is needed to refine protocols and enhance treatment outcomes.