Sibling Oocytes Randomly Assigned to Either Conventional Fertilization or Intracytoplasmic Sperm Injection Demonstrate Equivalent Fertilization and Blastulation Rates

Abstract

Background: To determine the difference in fertilization and blastulation rates between sibling oocytes randomly assigned to either Conventional Fertilization (CF) or Intracytoplasmic Sperm Injection (ICSI) in patient couples with normal semen analysis parameters. Methods:A retrospective review of embryologic and clinical outcomes from patients undergoing their first In Vitro Fertilization (IVF) cycle that randomly assigned one-half of sibling oocytes to either CF or ICSI. Randomization occurred prior to removal of the oocyte cumulus cells which allows identification of metaphase II oocytes eligible for ICSI. All male partners met normal semen analysis parameters and normal fertilization was anticipated for the IVF cycle. Each patient served as their own control.Results: A total of 682 oocytes were included and were assigned to either CF or ICSI. The CF had a significantly higher fertilization rate compared to ICSI (67.9% versus 60%) when immature (non-metaphase II) oocytes were included in the analysis; however this difference diminished when only those oocytes eligible for ICSI were included. There was no difference in the day-3 embryo progression, the blastulation rate, the mean number of oocytes fertilized and the mean number of blastocysts per IVF cycle. Additionally, there was no significant difference in the pregnancy related outcomes between the two groups.Conclusions: These studies demonstrates that in patient couples with normal semen analysis parameters, undergoing their first IVF cycle and who have anticipate normal fertilization, randomly assigning oocytes to CF or ICSI does not improve fertilization or blastulation. To confirm these findings, larger prospective studies are required.

Conventional IVF improves blastocyst rate and quality compared to ICSI when used in patients with mild or moderate teratozoospermia

“…They discovered that 36.8% of ICSI cycles were performed in non-male factor infertility cases, which led to a similar cumulative live birth rate compared to conventional IVF. Additionally, no differences in embryo development or in blastocyst formations or in pregnancy rates were reported several times before (Staessen et al 1999;Van Landuyt et al 2005;Foong et al 2006;Tobler et al 2014), but similarly to other topics in ART, also on this topic the opposite results were published. It was shown that ICSI can increase fertilization rates and good-quality embryo rates in patients with non-male factor indications (Khamsi et al 2001), can increase fertilization rates and lower complete fertilization failure in patients with polycystic ovarian syndrome and normozoospermic semen and in cases of unexplained inferility (Hershlag et al 2002;Hwang et al 2005), can increase normal and lower triploid fertilization rates leading to a higher mean number of embryos (but no improvement in pregnancy and implantation rate) in patients with endometriosis and normozoospermic semen (Komsky-Elbaz et al 2013) and can improve the fertilization rate, while at the same time lowering the pregnancy and delivery rate in patients with unexplained infertility (Check et al 2009).…”

Relevance of split In vitro fertilization-intracytoplasmic sperm injection method of insemination in normozoospermic and mildly oligospermic men: A retrospective study

“…Their study also showed an overall trend for improvement in the conventional IVF group over the ICSI group in the parameters studied though not statistically significant. [ 19 ]…”