Are we justified doing routine intracytoplasmic sperm injection in nonmale factor infertility? A retrospective study comparing reproductive outcomes between in vitro fertilization and intracytoplasmic sperm injection in nonmale factor infertility

Abstract

Introduction:Intracytoplasmic sperm insemination (ICSI) came into use in 1992 to improve fertilization in couples with male factor infertility undergoing in vitro fertilization (IVF) or in couples with fertilization failure in a prior IVF cycle. Our aim was to find out if routine ICSI has any additional benefit over conventional IVF in non male factor cases in modern Assisted Reproductive Technology (ART).Methods:This is a retrospective single centre study undertaken at a private IVF center. A total of 350 patients with normal male factor were included in the study of which 186 underwent conventional IVF and 134 were subjected to ICSI. They were then compared for various reproductive parameters with Live Birth Rate (LBR) being the primary outcome. P value < 0.05 was considered statistically significant.Results:Fertilization rates (89.99% vs 85.1%), Blastocyst formation rates (62.86% vs 50.61%) and clinical pregnancy rates (37.85% vs 32.35%) were found to be higher in the IVF group compared to the ICSI group though not statistically significant. The live birth rates in the IVF group was also higher than the ICSI group (32.71% vs 24.26%).Conclusion:IVF edged over ICSI in all aspects resulting in better clinical outcome with higher take home babies in non-male factor infertility. Our results show that routine ICSI should not be used as a blanket therapy for all cases in ART.

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

“…In 2002, a meta-analysis reported that if the standard insemination concentration of 0.2 × 10 6 /mL was utilized in those with mild MF, FR was improved if ICSI was used. Yet, this was no longer applicable if a higher concentration of 0.8 × 10 6 /mL was utilized [14]. However, when comparing these results to more recent results, Esteves et al noted that those with only mild MF, 5 × 10 6 /mL to <15 × 10 6 /mL and <32% forward motility, IVF, and ICSI had no difference in FR or LBR [31].…”

Reproductive outcomes of conventional in vitro fertilization and intracytoplasmic sperm injection in patients with non-severe male infertility across poor and different sub-optimal ovarian response categories: a cohort study based on 30352 fresh cycles from 2009-2019

“…Several studies have compared conventional IVF and ICSI in terms of embryonic outcomes (22)(23)(24). In most studies, there was no signi cant difference in the proportion of good-quality embryos and 2PN embryos (23,24).…”

“…Severe oligospermia and astheno-spermia were de ned as: sperm concentration 10×10 6 /ml and sperm with progressive motility rate (a+b) 10% in our clinical diagnostic criteria. A total of 30,352 cycles (22,472 conventional IVF cycles and 7,880 ICSI cycles) were included. Based on the number of oocytes retrieved, the included cycles were divided into three groups: 1-3 (n = 8,680), 4-6 (n = 1,071), and 7-9 (n = 11,101).…”