Use of intracytoplasmic sperm injection (<scp>ICSI</scp>) in normospermic men may result in lower clinical pregnancy and live birth rates

Sustar, Kylie; Rozen, Genia; Agresta, Franca; Polyakov, Alex

doi:10.1111/ajo.13004

Cited by 26 publications

(23 citation statements)

References 28 publications

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“…The other retrospective analysis from 2009-2015 with over 3000 patients found that FR and LBR per cycle were higher in IVF than ICSI (67.1% vs. 62.3% p < 0.0001, 17.22% vs. 13.2% p < 0.001, respectively). They stated that "one less pregnancy in every 15 cycles where ICSI was used without an indication" [11]. One study specifically attempted to look at the use of ICSI in NMF to help reduce TFF and improve embryo quality [12].…”

Section: Unselected Patientmentioning

confidence: 99%

The Impact of Intracytoplasmic Sperm Injection in Non-Male Factor Infertility—A Critical Review

Glenn

Kotlyar

Seifer

2021

JCM

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Intracytoplasmic sperm injection (ICSI) was originally designed to overcome barriers due to male factor infertility. However, a surveillance study found that ICSI use in non-male factor infertility increased from 15.4% to 66.9% between 1996 and 2012. Numerous studies have investigated fertilization rate, total fertilization failure, and live birth rate per cycle (LBR), comparing the use of ICSI versus conventional in vitro fertilization (IVF) for non-male factor infertility. The overwhelming conclusion shows no increase in fertilization rate or LBR per cycle with the use of ICSI for non-male factor infertility. The overuse of ICSI is likely related to the desire to avoid a higher rate of total fertilization failure in IVF. However, data supporting the benefit of using ICSI for non-male factor infertility is lacking, and 33 couples would need to be treated with ICSI unnecessarily to avoid one case of total fertilization failure. Such practice increases the cost to the patient, increases the burden on embryologist’s time, and is a misapplication of resources. Additionally, there remains conflicting data regarding the safety of offspring conceived by ICSI and potential damage to the oocyte. Thus, the use of ICSI should be limited to those with male factor infertility or a history of total fertilization factor infertility due to uncertainties of potential adverse impact and lack of proven benefit in non-male factor infertility.

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Section: Unselected Patientmentioning

confidence: 99%

The Impact of Intracytoplasmic Sperm Injection in Non-Male Factor Infertility—A Critical Review

Glenn

Kotlyar

Seifer

2021

JCM

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“…However, even this hypothesis would be questionable according to the results of a similar recent retrospective study on a large group of women with mean age 37, and normo-spermic partners [29]. In that study, which had a design similar to ours, the fertilization rate, the number of frozen embryos, the cumulative pregnancy rate and the live birth rate were significantly lower for the couples treated with ICSI.…”

Section: Discussionmentioning

confidence: 62%

ICSI versus Conventional IVF in Women Aged 40 Years or More and Unexplained Infertility: A Retrospective Evaluation of 685 Cycles with Propensity Score Model

Gennarelli¹,

Carosso²,

Canosa³

et al. 2019

JCM

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This study compared the cumulative live birth rates following Intracytoplasmic sperm injection (ICSI) versus conventional in vitro fertilization (cIVF) in women aged 40 years or more and unexplained infertility. A cohort of 685 women undergoing either autologous conventional IVF or ICSI was retrospectively analyzed. The effects of conventional IVF or ICSI procedure on cumulative pregnancy and live birth rates were evaluated in univariate and in multivariable analysis. In order to reduce potential differences between women undergoing either IVF or ICSI and to obtain unbiased estimation of the treatment effect, propensity score was estimated. ICSI was performed in 307 couples (ICSI group), whereas cIVF was performed in 297 couples (cIVF group), resulting in 45 and 43 live deliveries, respectively. No differences were observed in morphological embryo quality, in the number of cleavage stage embryos, in the number of transferred embryos, and in the number of vitrified embryos. As for the clinical outcome, no differences were observed in pregnancy rate, cumulative pregnancy rate, live birth rate, cumulative live birth rate, and abortion rate. The present results suggest that ICSI is not associated with increased likelihood of a live birth for unexplained, non-male factor infertility, in women aged 40 years or more.

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“…For preimplantation genetic testing (PGT) to be clinically applicable, intracytoplasmic sperm injection (ICSI) is usually required, rather than conventional in vitro fertilization (IVF) insemination method, owing to potential parental contamination from sperm and cumulus cells attached to the zona pellucida during conventional IVF (1)(2)(3)(4)(5)(6). However, in many available studies addressing non-male factor infertility, ICSI has not been proven to be beneficial for clinical outcomes, and the risk of chromosomal defects is increased in ICSI offspring (7)(8)(9)(10)(11)(12). Since sperm DNA fails to amplify under the conditions used for trophectoderm (TE) biopsy samples, and cumulus cells will be deliberately removed clearly in fresh IVF-PGT-A, the use of conventional IVF has been preliminarily explored in fresh genetic testing for aneuploidies (PGT-A) cycles in recent years (13)(14)(15).…”

Section: Introductionmentioning

confidence: 99%

Evaluate the risk in conventional IVF frozen human blastocysts undergoing PGT using a new quantification method for parental contamination testing (qPCT)

Dong¹,

Liu²,

Wan

et al. 2022

Preprint

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Objective: To establish a method to assess risks associated with preimplantation genetic testing (PGT) in embryos simultaneously with adhered sperm and cumulus cells. Design: A prospective pilot study. Setting: University teaching hospital. Patient(s): 120 frozen blastocysts that could be biopsied from 34 patients who had experienced repeated implantation failure or abortion due to chromosomal abnormalities after embryos transfer in prior routine IVF cycles. Intervention(s): Chromosome screening and parental DNA contamination testing was performed in the surplus frozen IVF blastocysts from 34 patients. Main Outcome Measure(s): Parental DNA contamination rate and euploidy rate in biopsied blastocysts. Result(s): A new quantification method for parental contamination testing (qPCT) in single-cell whole-genome amplification (WGA) products based on allelic ratio analysis was established and validated in an artificial model by comparing 22 results obtained before and after adding different numbers of sperm and cumulus cells to biopsied TE cells. The results of the prospective clinical study of qPCT-PGT-A showed that the maternal contamination rate was 0.83% (1/120) and the risk of paternal contamination was negligible. The euploidy rate in these blastocysts was 47.50% (57/120), and 21 frozen embryo transfer (FET) cycles resulted in ten ongoing clinical pregnancies and four healthy births. Conclusion(s): The evidence we provide in the study shows a low risk of PGT in embryos simultaneously with adhered sperm and cumulus cells. The qPCT assay can be used to detect the risk of potential contamination and ensure the accuracy of PGT results, thereby improving the clinical outcome of IVF.

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Use of intracytoplasmic sperm injection (ICSI) in normospermic men may result in lower clinical pregnancy and live birth rates

Abstract: This is the author manuscript accepted for publication and has undergone full peer review but has not been through the copyediting, typesetting, pagination and proofreading process, which may lead to differences between this version and the Version of Record. Please cite this article as

Cited by 26 publications

References 28 publications

The Impact of Intracytoplasmic Sperm Injection in Non-Male Factor Infertility—A Critical Review

The Impact of Intracytoplasmic Sperm Injection in Non-Male Factor Infertility—A Critical Review

ICSI versus Conventional IVF in Women Aged 40 Years or More and Unexplained Infertility: A Retrospective Evaluation of 685 Cycles with Propensity Score Model

Evaluate the risk in conventional IVF frozen human blastocysts undergoing PGT using a new quantification method for parental contamination testing (qPCT)

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