Intracytoplasmic sperm injection versus conventional in-vitro fertilisation in couples with infertility in whom the male partner has normal total sperm count and motility: an open-label, randomised controlled trial

Dang, Vinh Q.; Vuong, Lan N.; Luu, Tam M; Pham, Toan D; Ho, Tuong Vinh; Ha, Anh N.; Truong, Binh T; Phan, Anh K; Nguyen, Dung P; Pham, Thanh N; Trung, Phạm Quang; Wang, Rui; Norman, Robert J.; Mol, Ben Willem J.

doi:10.1016/s0140-6736(21)00535-3

Cited by 67 publications

(73 citation statements)

References 25 publications

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“…Even if results from a recent meta-analysis favour the use of ICSI to increase fertilization rates and decrease the risk of TFF in couples with well defined unexplained infertility, no data on the impact on clinical pregnancy and live birth rates have been provided in this publication [ 8 ]. A recent randomised clinical trial failed to demonstrate an advantage of ICSI compared to conventional IVF in couples without male factor indication in terms of total fertilization failure, live birth and implantation rates [ 7 ]. Since age has been correlated with zona pellucida thickening, ICSI has been proposed for improving ART outcomes in older patients [ 42 ]; however, a recent prospective randomized controlled trial comparing conventional insemination versus ICSI on sibling oocytes in advanced maternal age patients showed similar fertilization rate, average number of cleavage stage and average top-quality embryos between the two groups (9).…”

Section: Discussionmentioning

confidence: 99%

Should rescue ICSI be re-evaluated considering the deferred transfer of cryopreserved embryos in in-vitro fertilization cycles? A systematic review and meta-analysis

Paffoni

Reschini

Pisaturo

et al. 2021

Reprod Biol Endocrinol

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Background Total fertilization failure represents a particularly frustrating condition for couples undergoing in vitro fertilization. With the aim of reducing the occurrence of total fertilization failure, intracytoplasmic sperm injection (ICSI) has become the first choice over conventional in vitro fertilization (IVF) procedures although evidence of improved results is still debated and its use in couples without male factor infertility is not recommended. Among the strategies potentially useful to promote the use of conventional IVF, we herein call attention to the late rescue ICSI, which consists in performing ICSI after 18–24 h from conventional insemination on oocytes that show no signs of fertilization. This treatment has however been reported to be associated with a low success rate until recent observations that embryos derived from late rescue ICSI may be transferred after cryopreservation in a frozen-thawed cycle with improved results. The aim of the present study was to assess whether frozen embryos deriving from rescue ICSI performed about 24 h after conventional IVF may represent a valuable option for couples experiencing fertilization failure. Methods A systematic review on the efficacy of late rescue ICSI was performed consulting PUBMED and EMBASE. Results Including twenty-two original studies, we showed that clinical pregnancy rate per embryo transfer and implantation rate obtainable with fresh embryo transfers after rescue ICSI are not satisfactory being equal to 10 and 5%, respectively. The transfer of cryopreserved rescue ICSI embryos seems to offer a substantial improvement of success rates, with pregnancy rate per embryo transfer and implantation rate equal to 36 and 18%, respectively. Coupling rescue ICSI with frozen embryo transfer may ameliorate the clinical pregnancy rate for embryo transfer with an Odds Ratio = 4.7 (95% CI:2.6–8.6). Conclusion Results of the present review support the idea that r-ICSI coupled with frozen embryo transfer may overcome most of the technical and biological issues associated with fresh transfer after late r-ICSI, thus possibly representing an efficient procedure for couples experiencing fertilization failure following conventional IVF cycles. Trial registration Prospero registration ID: CRD42021239026.

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Section: Discussionmentioning

confidence: 99%

Should rescue ICSI be re-evaluated considering the deferred transfer of cryopreserved embryos in in-vitro fertilization cycles? A systematic review and meta-analysis

Paffoni

Reschini

Pisaturo

et al. 2021

Reprod Biol Endocrinol

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“…This study found that compared with stimulation therapy, minimal stimulation and natural cycle are associated with the occurrence of LFR/TFF. Previous studies reported some discrepancies in the fertilization rate after ICSI and conventional IVF between studies ( 35 , 36 ). Some studies showed a lower fertilization rate after ICSI ( 37 , 38 ), whereas others reported no difference or a significantly higher fertilization rate after ICSI ( 39 – 42 ).…”

Section: Discussionmentioning

confidence: 90%

Prediction of Fertilization Disorders in the In Vitro Fertilization/Intracytoplasmic Sperm Injection: A Retrospective Study of 106,728 Treatment Cycles

et al. 2022

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PurposeThis study aimed to develop a risk prediction of fertilization disorders during the in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI).MethodsA retrospective study was performed with 106,728 fresh embryo IVF/ICSI cycles from 2009 to 2019. Basic characteristics of patients, clinical treatment data, and laboratory parameters were involved. The associations between the selected variables and risks for low fertilization rate (LFR) and total fertilization failure (TFF) were investigated. Ordinal logistic regression and the receiver operating characteristic curves (ROCs) were used to construct and evaluate the prediction models.ResultsA total of 97,181 controls, 4,343 LFR and 5,204 TFF cases were involved in this study. The model based on clinical characteristics (the ages of the couples, women’s BMI, types of infertility, ART failure history, the diminished ovarian reserve, sperm quality, insemination method, and the number of oocytes retrieved) had an AUC of 0.743 for TFF. The laboratory model showed that primary infertility, ART failure history, minimal-stimulation cycle/natural cycle, numbers of oocyte retrieved < 5, IVF, and Anti-Mullerian hormone (AMH) level < 1.1ng/ml are predictors of TFF, with an AUC of 0.742.ConclusionWe established a clinical and a laboratory prediction model for LFR/TFF. Both of the models showed relatively high AUCs.

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“…No other industry can pass on the risk burden to the state while keeping the profits only. ICSI instead of IVF is disproportionately used without evidence in order to optimise profits and has become the primary therapeutic approach for couples with `unexplained infertility ( Dang et al ., 2021 ). Technology creep has disproportionately increased `add-ons,’ while the cryopreservation industry with 3.1-9.3% usage of frozen material sets the cost of each extra LB between $600,000-1,000,000 ( Ben-Rafael, 2018 ).…”

Section: Economic and Safety Evidencementioning

confidence: 99%

Global inequality in sub-fertility treatment needs safer, cost effective, evidence-based and economically viable choices for patients and stakeholders

Bahadur¹,

Homburg²,

Muneer³

et al. 2022

JBRA Assisted Reproduction

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The global increase in subfertility diagnosis and treatments and the rise of private equity investors concentrating on high profits based on in vitro fertilisation (IVF) treatments raise profound societal and economic questions for stakeholders and patients. The question remains as to whose benefits will ultimately be greater when promoting high margins treatment options resulting from cross-border mergers and acquisitions of IVF clinics.This paper covers wide-ranging issues from the erroneously constructed UK National Institute for Health and Care Excellence’s (NICE) guidelines on treatment choices, the cost-effectiveness of treatments, the promotion of IVF, and add-ons where evidence remains minimal, the commercial size of the fertility industry. Investment in improving intrauterine insemination (IUI) success rates has understandably been avoided for its short-term impact on the IVF industry. However, IUI efficiency would cut across many of the global subfertility treatment economic and access problems while allowing stakeholder, feepaying, and patients financial savings will likely allow for more funded IVF cycles in acutely deserving cases. The recommendations will help expand choices for globally economically challenged patients’ and services while enhancing an ethical and moral dimension towards fertility treatment choices for patients and stakeholders.

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Intracytoplasmic sperm injection versus conventional in-vitro fertilisation in couples with infertility in whom the male partner has normal total sperm count and motility: an open-label, randomised controlled trial

Cited by 67 publications

References 25 publications

Should rescue ICSI be re-evaluated considering the deferred transfer of cryopreserved embryos in in-vitro fertilization cycles? A systematic review and meta-analysis

Should rescue ICSI be re-evaluated considering the deferred transfer of cryopreserved embryos in in-vitro fertilization cycles? A systematic review and meta-analysis

Prediction of Fertilization Disorders in the In Vitro Fertilization/Intracytoplasmic Sperm Injection: A Retrospective Study of 106,728 Treatment Cycles

Global inequality in sub-fertility treatment needs safer, cost effective, evidence-based and economically viable choices for patients and stakeholders

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