In assisted reproduction by IVF or ICSI, the rate at which embryos develop to the blastocyst stage is influenced by the fertilization method used: a split IVF/ICSI study

Abstract

Purpose To compare in vitro fertilization (IVF) with intracytoplasmic sperm injection (ICSI) in regard to post-fertilization development and outcome with the purpose of ascertaining the most effective fertilization method for assisted reproduction. Methods A retrospective cohort study of 136 split IVF/ICSI cycles (where sibling oocytes are fertilized by two different methods using the same sperm sample). Results IVF-derived embryos developed to the blastocyst stage at a significantly faster rate than ICSI-derived embryos. There was no significant difference in fertilization or livebirth rates between the two fertilization methods. Conclusions For patients with sperm progressive motility ≥ 1.0 × 10 6 /ml (who usually constitute the majority of patients), no significant difference between the two fertilization methods was found in regard to fertilization rate or livebirth rate. Remaining factors influencing choice between the two methods appear to be restricted to convenience, financial considerations and concern with regard to possible perpetuation of genetically linked infertility to future generations.

More blastocysts are produced from fewer oocytes in ICSI compared to IVF – results from a sibling oocytes study and definition of a new key performance indicator

“…In concordance with our results analyzed in their globality and by sub-groups, previous authors applying split insemination found significant higher fertilization rate in ICSI compared to IVF [11,[15][16][17]28], comparable cleavage rate [10-12, 14, 15, 20], no statistical difference in blastocyst rate [11,13], comparable implantation [10,12] and live birth rates [13,16].…”

“…Previous authors applying split insemination reported data from embryo development until cleavage stage [ 10 , 12 , 15 , 16 ] or on a minor number of cases [ 11 , 13 , 14 , 18 , 28 ]. The present study is the first one focused mainly on blastocyst stage, and on such a high number of cases that could also be analyzed according to different clinical parameters.…”

“…The Key Performance Indicators (KPIs) applied to compare the two fertilization methods were fertilization and cleavage rates, embryo quality, the percentage of transferred and frozen embryos on zygote number, and clinical outcome measurements such as implantation and clinical pregnancy rates. Different studies found the two fertilization methods comparable and suggest applying IVF when possible [12][13][14] even when the fertilization rate was higher in ICSI [11,[15][16][17]. In all cases, the authors tested the goodness of IVF and ICSI procedures in their lab from a technical perspective.…”

A scientometric analysis of research publications on male infertility and assisted reproductive technology

“…Although IVF revolutionised infertility treatment, poor semen quality remains associated with poor outcomes in IVF (Stephens et al, 2013). ICSI involves the injection of a single spermatozoon into the oocyte; thus, it represents the gold standard technique in case of cryptozoospermia (Palermo et al, 1992(Palermo et al, , 2017, whereas in IVF, a minimum seminal concentration of 200,000 motile spermatozoa/mL is required for fertilization (Speyer et al, 2019).…”

“…ICSI has been successfully applied to overcome severe male factor infertility presentations, including oligozoospermia, asthenozoospermia and teratozoospermia, or a combination of these, as well as in case of recurrent IVF failures (Palermo, Neri, Schlegel, & Rosenwaks, 2014;Speyer et al, 2019). Furthermore, ICSI bypasses sperm kinetic defects, the presence of anti-sperm antibodies, acrosome dysfunction and the lack of maturity in gametes collected directly from the epididymis or testicles (Palermo et al, 2014).…”