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

Gennarelli, Gianluca; Carosso, Andrea; Canosa, Stefano; Filippini, Claudia; Cesarano, Sara; Scarafia, Carlotta; Brunod, Nicole; Revelli, Alberto; Benedetto, Chiara

doi:10.3390/jcm8101694

Cited by 21 publications

(21 citation statements)

References 42 publications

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“…Large studies comparing the results of cIVF and ICSI for the treatment of non-male factor infertility showed quite clearly that ICSI cannot offer any advantage in terms of clinical outcome [19][20][21]. Nevertheless, data showing that ovarian endometriosis negatively affects oocyte quality [8][9][10] led to the idea that using ICSI instead of cIVF could be advantageous for this specific subset of patients.…”

Section: Discussionmentioning

confidence: 99%

Does Ovarian Endometriosis Increase Oocyte Sensitivity to ICSI-Induced Mechanical Damage?

Scarafia

Masciovecchio

Canosa

et al. 2021

JCM

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Some studies have shown that ICSI obtains poorer results than conventional IVF in women with ovarian endometriosis, suggesting that oocytes could be sensitive to ICSI-induced mechanical damage. The aims of this study were to clarify (a) whether ovarian endometriosis could induce peculiar fragility in the oocyte, so that ICSI would finally result harmful, and (b) whether endometrioma removal before IVF could be advisable in order to avoid any hypothetical detrimental effect. We retrospectively studied 368 women, 203 with in situ endometrioma (128 of which underwent ICSI, 75 conventional IVF) and 164 who received laparoscopic stripping of endometrioma before ICSI. For women with in situ endometrioma, cIVF and ICSI outcome was comparable for all parameters studied, including the clinical pregnancy rate per embryo transfer (PR/ET: 31.8% vs. 39.5% in the cIVF and ICSI groups) and cumulative live birth rate per ovum pick-up (CLBR/OPU: 24.4% vs. 27.7%). ICSI outcome was similar comparing women with in situ endometrioma and women previously submitted to laparoscopic stripping of cysts (CLPR/OPU 27.7% vs. 25.3%). Our findings suggest that (a) in women with in situ endometrioma ICSI may be performed, when needed, without harming oocytes and compromising the outcome and (b) that there is no advantage in removing endometrioma before ICSI.

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Section: Discussionmentioning

confidence: 99%

Does Ovarian Endometriosis Increase Oocyte Sensitivity to ICSI-Induced Mechanical Damage?

Scarafia

Masciovecchio

Canosa

et al. 2021

JCM

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“…6 While ICSI has resulted in high success rates in couples treated for severe male factor infertility, studies have indicated that ICSI offers no advantage over conventional IVF in nonmale factor infertility couples when it comes to live birth rates. [7][8][9][10][11] Moreover, the American Society for Reproductive Medicine recently published a committee opinion stating that 'in cases without male factor infertility or a history of prior fertilisation failure, the routine use of ICSI for all oocytes is not supported by the available evidence'. 12 In the US study from 2018, the large increase in use of ICSI was correlated with a 7.6% (p=0.001) increase in live birth rates per cycle in women younger than 35 years.…”

Section: Strengths and Limitations Of This Studymentioning

confidence: 99%

In vitro fertilisation (IVF) versus intracytoplasmic sperm injection (ICSI) in patients without severe male factor infertility: study protocol for the randomised, controlled, multicentre trial INVICSI

et al. 2021

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IntroductionOver the last decades, the use of intracytoplasmic sperm injection (ICSI) has increased, even among patients without male factor infertility. The increase has happened even though there is no evidence to support that ICSI results in higher live birth rates compared with conventional in vitro fertilisation (IVF) in cases with nonmale factor infertility. The lack of robust evidence on an advantage of using ICSI over conventional IVF in these patients is problematic since ICSI is more invasive, complex and requires additional resources, time and effort. Therefore, the primary objective of the IVF versus ICSI (INVICSI) study is to determine whether ICSI is superior to standard IVF in patients without severe male factor infertility. The primary outcome measure is first live birth from fresh and frozen-thawed transfers after one stimulated cycle. Secondary outcomes include fertilisation rate, ongoing pregnancy rate, birth weight and congenital anomalies.Methods and analysisThis is a two-armed, multicentre, randomised, controlled trial. In total, 824 couples/women with infertility without severe male factor will be recruited and allocated randomly into two groups (IVF or ICSI) in a 1:1 ratio. Participants will be randomised in variable block sizes and stratified by trial site and age. The main inclusion criteria are (1) no prior IVF/ICSI treatment, (2) male partner sperm with an expected count of minimum 2 million progressive motile spermatozoa following density gradient purification on the day of oocyte pick up and (3) age of the woman between 18 and 42 years.Ethics and disseminationThe study will be performed in accordance with the ethical principles in the Helsinki Declaration. The study is approved by the Scientific Ethical Committee of the Capital Region of Denmark. Study findings will be presented, irrespectively of results at international conferences and submitted for publication in peer-reviewed journals.Trial registration numberNCT04128904. Pre-results.

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“…Conventional IVF is known as an effective technique for fertilization and successful embryo development in case of non-male infertility factors. Several studies have shown that conventional IVF is a better approach than ICSI when sperm concentration, motility and morphology are normal (Bhattacharya et al, 2001;Gennarelli et al, 2019;Stimpfel et al, 2019). During the conventional IVF process, ROS can originate from dead spermatozoa and white blood cells of sperm.…”

Section: Oxidative Stress In Assisted Reproduction Techniques (Art)mentioning

confidence: 99%

“…ICSI was designed to overcome unexplained infertility, poor quality embryo retrieval, advanced maternal age, severe form of male infertility, (Feldman et al, 2017), fertilization after in vitro maturation and fertilization of frozen-thawed oocytes (Luna et al, 2011; Practice Committees of the American Society for Reproductive Medicine and Society for Assisted Reproductive Technology, 2012; Tannus et al, 2017). In this way, ICSI is an efficient technique that can prevent 30% of fertilization failures (Tournaye et al, 2002;Gennarelli et al, 2019). During ICSI procedures, cumulus cell removal can deprive oocytes from protection against irreversible oxidative damage, during maturation and fertilization.…”

Section: Oxidative Stress In Assisted Reproduction Techniques (Art)mentioning

confidence: 99%

Reactive oxygen species in reproduction: harmful, essential or both?

Jamil

Debbarh

Aboulmaouahib³

et al. 2020

Zygote

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Summary The process of embryonic development is crucial and radically influences preimplantation embryo competence. It involves oocyte maturation, fertilization, cell division and blastulation and is characterized by different key phases that have major influences on embryo quality. Each stage of the process of preimplantation embryonic development is led by important signalling pathways that include very many regulatory molecules, such as primary and secondary messengers. Many studies, both in vivo and in vitro, have shown the importance of the contribution of reactive oxygen species (ROS) as important second messengers in embryo development. ROS may originate from embryo metabolism and/or oocyte/embryo surroundings, and their effect on embryonic development is highly variable, depending on the needs of the embryo at each stage of development and on their environment (in vivo or under in vitro culture conditions). Other studies have also shown the deleterious effects of ROS in embryo development, when cellular tissue production overwhelms antioxidant production, leading to oxidative stress. This stress is known to be the cause of many cellular alterations, such as protein, lipid, and DNA damage. Considering that the same ROS level can have a deleterious effect on the fertilizing oocyte or embryo at certain stages, and a positive effect at another stage of the development process, further studies need to be carried out to determine the rate of ROS that benefits the embryo and from what rate it starts to be harmful, this measured at each key phase of embryonic development.

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

Cited by 21 publications

References 42 publications

Does Ovarian Endometriosis Increase Oocyte Sensitivity to ICSI-Induced Mechanical Damage?

Does Ovarian Endometriosis Increase Oocyte Sensitivity to ICSI-Induced Mechanical Damage?

In vitro fertilisation (IVF) versus intracytoplasmic sperm injection (ICSI) in patients without severe male factor infertility: study protocol for the randomised, controlled, multicentre trial INVICSI

Reactive oxygen species in reproduction: harmful, essential or both?

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