Comparison of clinical outcomes between in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI) in IVF-ICSI split insemination cycles

Abstract

ObjectiveThis study aimed to compare the clinical outcomes between in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI) in sibling oocytes. Additionally, we evaluated whether the implementation of split insemination contributed to an increase in the number of ICSI procedures.MethodsA total of 571 cycles in 555 couples undergoing split insemination cycles were included in this study. Among them, 512 cycles (89.7%) were a couple's first IVF cycle. The patients were under 40 years of age and at least 10 oocytes were retrieved in all cycles. Sibling oocytes were randomly allocated to IVF or ICSI.ResultsTotal fertilization failure was significantly more common in IVF cycles than in ICSI cycles (4.0% vs. 1.4%, p<0.05), but the low fertilization rate among retrieved oocytes (as defined by fertilization rates greater than 0% but <30%) was significantly higher in ICSI cycles than in IVF cycles (17.2% vs. 11.4%, p<0.05). The fertilization rate of ICSI among injected oocytes was significantly higher than for IVF (72.3%±24.3% vs. 59.2%±25.9%, p<0.001), but the fertilization rate among retrieved oocytes was significantly higher in IVF than in ICSI (59.2%±25.9% vs. 52.1%±22.5%, p<0.001). Embryo quality before embryo transfer was not different between IVF and ICSI. Although the sperm parameters were not different between the first cycle and the second cycle, split insemination or ICSI was performed in 18 of the 95 cycles in which a second IVF cycle was performed.ConclusionThe clinical outcomes did not differ between IVF and ICSI in split insemination cycles. Split insemination can decrease the risk of total fertilization failure. However, unnecessary ICSI is carried out in most split insemination cycles and the use of split insemination might make ICSI more common.

Thyroid Disorders and In Vitro Outcomes of Assisted Reproductive Technology: An Unfortunate Combination?

“…In some studies, ICSI has been associated with better FRs compared with that in IVF cycles (39). ICSI has been used for over 20 years, and high FRs have been reported since its implementation (40).…”

“…ICSI has been used for over 20 years, and high FRs have been reported since its implementation (40). The concept that in women with TAI, ICSI might be the better ART technique is based on the fact that, in contrast to IVF, it may overcome the impact of thyroid antibodies in the FF (hampering the interaction between the oocyte and the sperm cell) (6,39). However, in our logistic regression analysis, ICSI was not a predictor for a high FR.…”

Embryo transfer associated with hormone replacement therapy cycles using assisted reproductive technology increases placenta accreta spectrum

“…Few studies have investigated the ART parameters associated with the risk of perinatal obstetric outcomes . Successful ART depends on the quality of the embryo and endometrial receptivity at the time of pre‐implantation . In the present study, we performed analyses on the effects of HRT use in ET and the risk of developing major perinatal obstetric complications, including placenta accreta spectrum, placental abruption, placenta previa, HDP and SGA fetuses.…”

Obstetric outcomes after fresh versus frozen-thawed embryo transfers: A systematic review and meta-analysis

“…Elucidating the IVF effects on obstetric outcomes in singleton pregnancies is of utmost importance in the field of reproductive medicine and mother-child health. Successful IVF depends not only on the quality of the embryo ( Lee et al ., 2017 ), but also on endometrial receptivity and the environmental conditions of the uterus during the pre-implantation period ( Barnhart, 2014 ; Schoolcraft et al ., 2017 ; Shapiro et al ., 2014 ). With continuing research in this area, updated knowledge on endometrial-embryo interactions can help researchers and clinicians better understand the positive and negative outcomes of IVF.…”