Conventional in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI): which is preferred for advanced age patients with five or fewer oocytes retrieved?

Liu, Hui; Zhao, Hongxia; Yu, Guanling; Li, Mei; Ma, Shanshan; Zhang, Haozhen; Wu, Keliang

doi:10.1007/s00404-018-4696-6

Cited by 26 publications

(19 citation statements)

References 23 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Importantly, the study did remark that the more mature oocytes may have been selected by the embryologist preferentially for ICSI, thus introducing selection bias with the results skewing in favor of ICSI [22]. Liu et al's retrospective cohort of 644 patients from 2011-2016, women 40-43 years old in their first IVF cycle, with the same protocol and low egg yield, found an increase in cumulative LBR per cycle for the IVF group after adjusting for primary infertility (14.6% vs. 5.6%, p < 0.05) [19]. In a similar fashion, a 10-year retrospective review of women 35 years old or greater showed an increase in LBR per cycle in women who received IVF compared to ICSI (aOR 2.64, p < 0.0001) [26].…”

Section: Advanced Maternal Agementioning

confidence: 99%

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

Glenn

Kotlyar

Seifer

2021

JCM

View full text Add to dashboard Cite

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.

show abstract

Section: Advanced Maternal Agementioning

confidence: 99%

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

Glenn

Kotlyar

Seifer

2021

JCM

View full text Add to dashboard Cite

show abstract

“…When available data were pooled together, pregnancy rate per cycle was 13.1% ( n = 127/967) in c-IVF and 7.3% ( n = 61/831) in ICSI cycles ( p < 0.001). Live birth rates per c-IVF and ICSI cycles in women aged 40 years or more were 12.2% versus 6.0% in Liu et al [ 58 ] and 18.8% versus 14.5% in Tannus et al [ 59 ], respectively. Pooled live birth rates per cycle in women aged 40 years or more were 9.6% (76/789) and 7.7% (46/600) in c-IVF and ICSI, respectively ( p = 0.20).…”

Section: Conventional Ivf Art Indications and Clinical Situationsmentioning

confidence: 98%

Opportunities and Limits of Conventional IVF versus ICSI: It Is Time to Come off the Fence

Balli

Cecchele²,

Pisaturo³

et al. 2022

JCM

View full text Add to dashboard Cite

Conventional IVF (c-IVF) is one of the most practiced assisted reproductive technology (ART) approaches used worldwide. However, in the last years, the number of c-IVF procedures has dropped dramatically in favor of intracytoplasmic sperm injection (ICSI) in cases of non-male-related infertility. In this review, we have outlined advantages and disadvantages associated with c-IVF, highlighting the essential steps governing its success, its limitations, the methodology differences among laboratories and the technical progress. In addition, we have debated recent insights into fundamental questions, including indications regarding maternal age, decreased ovarian reserve, endometriosis, autoimmunity, single oocyte retrieval-cases as well as preimplantation genetic testing cycles. The “overuse” of ICSI procedures in several clinical situations of ART has been critically discussed. These insights will provide a framework for a better understanding of opportunities associated with human c-IVF and for best practice guidelines applicability in the reproductive medicine field.

show abstract

“…Additionally, the lower handling of oocytes and more physiological gamete interaction observed in IVF may advocate for its preferential use when ICSI is not mandatory. It could even be anticipated that this minimal disturbance of oocytes would be even more beneficial in cases where a low oocyte quality and/or high susceptibility to manipulation is observed, such as advanced maternal age or low ovarian reserve (26). Still, this was not confirmed by our results because neither subgroup analysis in poor responders nor meta-regression on the basis of female age identified any significant difference between IVF and ICSI in terms of LBR, when male factor infertility is not identified.…”

Section: Icsi Overuse In Non-male Factor Infertilitymentioning

confidence: 99%

“…This was not, however, observed. Of the articles included in this meta-analysis, 4 analyzed CLBR after fresh and frozen transfers (7,8,25,26). Three (7,8,25) showed no significant difference in terms of CLBR in IVF vs. ICSI, and 1 (26) reported significantly increased CLBR with IVF than with ICSI.…”

Section: Study Limitationsmentioning

confidence: 99%

Does intracytoplasmic sperm injection improve live birth rate when compared with conventional in vitro fertilization in non-male factor infertility? A systematic review and meta-analysis

Bantel-Finet¹,

Arbo²,

Colombani³

et al. 2022

F&S Reviews

View full text Add to dashboard Cite

Objective: To determine whether the use of intracytoplasmic sperm injection (ICSI), which was initially developed for sperm abnormalities but has progressively expanded beyond male factor infertility, improves live birth rate (LBR) compared with conventional in vitro fertilization (IVF) in non-male factor infertility cases. Evidence Review: This prospectively registered systematic review and meta-analysis was guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. PubMed, Embase, and Cochrane Library were searched for relevant literature reported between January 01, 2004, and March 15, 2020. Only articles conducted in couples without obvious male factor infertility according to the investigators were included. Live birth rate (LBR) per cycle and/or per transfer was used as the main outcome. Fertilization rate, cycles with total fertilization failure, and clinical pregnancy rate were also recorded as the secondary outcomes. Study selection, bias assessment, and data extraction were performed by two independent reviewers. The methodological quality of the selected studies was assessed by two independent reviewers using the Cochrane Handbook methods and by the adapted Newcastle-Ottawa Quality Assessment Scale for cohort studies. The risks of bias were assessed using the ROBIN-1 tools. Risk ratio (RR) and 95% confidence interval (CI) were estimated using the random-effects model. Results: Among the 1,760 potentially eligible studies, 61 were fully assessed, and 21 were included in the meta-analysis, corresponding to almost 1,000,000 assisted reproductive technology cycles. Among the selected studies, 17 reported LBR per cycle, 11 reported LBR per transfer, and 7 among them reported both outcomes. One was a prospective randomized controlled trial, whereas others were either retrospective cohort (n¼17) or case-control studies (n¼4). Individual studies' sample size ranged from 60 to 569,605 cycles. Metaanalysis showed that IVF provided a significantly higher LBR per cycle when compared with ICSI (RR, 1.10; 95% CI, 1.02-1.18). LBR per transfer tended to be higher when IVF was used compared with ICSI, but this difference barely reached statistical significance (RR, 1.18; 95% CI, 1.00-1.38). Subgroup analysis performed in poor responders showed no significant difference between IVF and ICSI concerning LBR per cycle or LBR per transfer. The secondary analyses demonstrated a lower fertilization rate but comparable clinical pregnancy and fertilization failure rates with IVF compared with ICSI. Sensitivity analyses led to similar results and conclusions.

show abstract

Conventional in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI): which is preferred for advanced age patients with five or fewer oocytes retrieved?

Abstract: Our study provides strong evidences that the conventional IVF exhibits advantages over the ICSI method in non-male factor infertility for advanced age patients with five or fewer oocytes retrieved.

Cited by 26 publications

References 23 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

Opportunities and Limits of Conventional IVF versus ICSI: It Is Time to Come off the Fence

Does intracytoplasmic sperm injection improve live birth rate when compared with conventional in vitro fertilization in non-male factor infertility? A systematic review and meta-analysis

Contact Info

Product

Resources

About