Conventional in-vitro fertilization versus intracytoplasmic sperm injection in sibling oocytes from couples with tubal infertility and normozoospermic semen

Abstract

An auto-controlled study was conducted in couples with tubal infertility and normozoospermic semen. The fertilization rates and embryonic development in sibling oocytes treated, using the same semen sample, either by conventional in-vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI) at the same time were compared. Sibling oocyte-cumulus complexes (OCC) of 56 different couples with tubal infertility and normozoospermic semen were randomly divided in order of retrieval into two groups inseminated either by conventional IVF or by ICSI. Of the retrieved OCC in the same cohort, 53.0 +/- 31.2 and 62.0 +/- 26.6% showed two distinct pronuclei after conventional IVF and ICSI respectively (not significant). Complete fertilization failure occurred after conventional IVF in 12.5% (7/56 couples). After ICSI, the comparable figure was 3.6% (2/56). The number of cases was too small to apply a statistical test to this difference. Total cleavage rates were quite similar: 86.7 +/- 28.0 and 90.1 +/- 21% of the zygotes developed into transferable embryos after IVF and ICSI respectively (not significant). Similarly, no difference in embryo quality was observed. Although injection and insemination of the oocytes were performed at the same time in the two groups, at 42 h post-insemination more embryos were at the four-cell stage after ICSI (P < 0.001) than after conventional IVF, where more embryos were still at the two-cell stage (P < 0.02). Embryo transfer was possible in all 56 couples, resulting in 16 positive serum human chorionic gonadotrophin tests (28.6% per embryo transfer), from which a clinical pregnancy resulted in 15 couples. The best embryos were selected for transfer independently of the insemination procedure, but preferably from the same origin. There appeared to be no difference in implantation potency of the embryos obtained with either technique after the non-randomized transfers.

Conventional IVF versus ICSI in sibling oocytes from couples with endometriosis and normozoospermic semen

“…Hence, micromanipulation technique appears to have no negative effect on the embryonic development. These results are in view of previous studies, which found no differences in the embryo development in sibling oocytes regardless of the fertilization procedure [23,37].…”

“…Finally, a comparison between embryo transfer cycles in which either ICSI only or IVF only embryos were transferred revealed no statistically significant differences in pregnancy rate, implantation rate or pregnancy outcome. Previous studies found similar fertilization rates of sibling oocytes inseminated by either ICSI or conventional IVF in couples with tubal infertility and normozoospermic semen [23][24][25]. In contrast, in the current study we found a significantly higher fertilization rate of oocytes inseminated by ICSI as compared to conventional IVF.…”

“…Since exposure of the oocytes to the spermatozoa was impossible, proof of the fecundity of the apparently normal spermatozoa is absent. During the IVF procedure, the mechanical barrier is removed and the fecundity of the spermatozoa can be proven in vitro [23]. In contrast, in women with endometriosis one possible mechanism for reduced fertilization rates is compromised oocyte quality [3,[26][27][28].…”

Short Communication: Cryopreserved Sibling Oocytes and Intracytoplasmic Sperm Injection Rescue Unexpectedly Poor Fertilization in Conventional In Vitro Fertilization

“…ICSI is powerful for treating male-factor infertility that could not be assisted using conventional IVF. However, unexpected fertilization failures from IVF in couples with normal semen may occasionally occur (14,15). There are no absolute parameters or sperm function tests to predict fertilization outcome for apparently normal semen.…”

“…Some investigators attempted IVF-ICSI split on fresh sibling oocytes as the insemination method for normal semen to prevent fertilization failures (14,15). For couples with tubal or unexplained infertility, they found that the use of ICSI rescued 9-16% of cycles where IVF failed.…”