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**7. Conclusion** 

**Author details** 

**8. References** 

35.

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In our research, we tested only 7 women with rare mutations F V Leiden (1691 G>A) and FII (20210 G>A), associated with thrombosis, pregnancy failure and reproductive technologies. Therefore, we were unable to prove their relevance to IVF outcomes. A common gene polymorphisms MTHFR (C 677> T) and gene PAI 1 (5G>4G) compared with the results of

The research marks the opportunities to progress and improve outcomes of IVF based on the identification and correction of the pathology of hemostasis and fibrinolysis. The research data may serve as the basis for the development of guidelines and standards which allow improving the efficiency of modern reproductive technologies. The marked problem requires interdisciplinary approach, joint efforts by obstetricians and hematologists and reward by better efficiency of IVF despite the increased cost of diagnosis and treatment of

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**Chapter 5** 

© 2012 Javed and Michael, licensee InTech. This is an open access chapter distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

© 2012 Javed and Michael, licensee InTech. This is a paper distributed under the terms of the Creative Commons

The risk of oocyte damage by the ICSI procedure is low in humans and is due to both the skill of the person performing the injection procedure and the quality of the gametes used

**Intracytoplasmic Sperm Injection –** 

The ICSI has become method of choice to achieve fertilization. Fertilization is possible in cases in which the sperm motility and ability to penetrate the zona pellucida are impaired. Injection is possible with sperm obtained from ejaculation, microsurgical epididymal sperm aspiration (MESA), percutaneous epididymal sperm aspiration (PESA), or testicular sperm extraction (TESE). In addition, indications for ICSI include idiopathic infertility and repeated conventional *in vitro* fertilization (IVF) failures [1]. Fertilization rate after ICSI is at about 70 to 80% in all ages combined [2]. This suggests that, despite injecting sperm into mature oocytes, failed fertilization still occurs. Total failed fertilization (TFF) refers to failure of fertilization in all mature oocytes and "failed fertilization" refers to failure of fertilization in any mature oocyte. Based on a considerable emotional and financial involvement in a cycle of assisted reproduction, TFF is a distressful event for the infertile couple as well as the fertility professionals. TFF occurs in 5–10% of IVF [3] and 1-3% of ICSI cycles [4]. TFF after ICSI cycles is mostly due to low number of mature oocytes [4] or oocyte activation failure [5]. TFF is a rare event in cases with normal oocytes and sperm [6]. Some patients may face repeated TFF in spite of normal sperm parameters and good ovarian response [7]. In such cases, the primary reason for failed fertilization after ICSI is lack of oocyte activation, as more than 80% of these oocytes contain a sperm [4]. Considerable advances in artificial oocyte activation and recovery of sperm from epididymis or testis, suitable for ICSI, help avoid TFF. This chapter discusses the factors affecting success rate of ICSI, highlights causes

of failure and suggests remedies for failed fertilization after clinical ICSI.

**2. Procedural effects of ICSI technique** 

**Factors Affecting Fertilization** 

Additional information is available at the end of the chapter

Murid Javed and Essam Michael

http://dx.doi.org/10.5772/50036

**1. Introduction** 

