P-196 PIEZO-intracytoplasmic sperm injection (P-ICSI) can improve the clinical outcomes of ICSI

Abstract

Study question Can P-ICSI improve the clinical outcomes of ICSI, such as degeneration, fertilization and development to blastocyst, compared to conventional ICSI (C-ICSI)? Summary answer P-ICSI can improve the clinical outcomes of ICSI by increasing the number of fertilized oocytes and decreasing the number of degenerated oocytes after ICSI. What is known already In human IVF-ET, some of oocytes are damaged after ICSI when retrieved oocytes are inseminated by ICSI. The application of P-ICSI has been limited although it was developed over 30 years ago. Recently, it has been reported that P-ICSI can decrease damage after ICSI and improve fertilization and embryonic development compared to C-ICSI. Study design, size, duration This study included 50 subjects undergoing IVF and was performed between April and October 2022. Sibling oocytes were randomly assigned to C-ICSI and P-ICSI. Participants/materials, setting, methods A total of 1,207 oocytes were retrieved from 50 patients. Among them, 852 oocytes with visible spindle were inseminated by C-ICSI or P-ICSI in sibling oocytes. Four hundred twenty-five oocytes were inseminated by C-ICSI and 427 oocytes were by P-ICSI. Fertilization, degeneration after ICSI and blastocyst development on day 5 or day 6 were compared between the P-ICSI and C-ICSI. The differences between C-ICSI and P-ICSI were statistically analyzed using Mann-Whitney U test. Main results and the role of chance Normal fertilization rate of P-ICSI (78.2 ± 16.5%) were higher than that of C-ICSI (71.2 ± 18.9%). The difference was statistically significant (P = 0.0447). The oocyte degeneration rates after ICSI were 9.3 ± 11.8% (C-ICSI) and 4.8 ± 9.4% (P-ICSI). The degeneration rate of C-ICSI was significantly higher than that of P-ICSI (P = 0.04338). Blastocyst formation rate of C-ICSI was 58.6 ± 25.0% and that of P-ICSI was 64.3 ± 26.3%. The blastocyst formation rate of P-ICSI was higher than that of C-ICSI but the difference was not statistically significant (P = 0.2113). The rates of blastocysts that were available for embryo replacement or cryopreservation were higher in P-ICSI (56.0 ± 25.4%) than in C-ICSI (50.4 ± 24.7%) although the difference was not significant (P = 0.26272). Limitations, reasons for caution Pregnancy outcomes data were not available. The data of this study were obtained from single fertility center. More large-scale multicenter studies will be needed to confirm the effectiveness of P-ICSI. Wider implications of the findings Consistent with other studies, these results show that P-ICSI reduces the damage rate of oocytes after ICSI. The implementation of P-ICSI has the potential to improve clinical outcomes of human IVF although it is more complicated and takes longer than that of C-ICSI. Trial registration number not applicable