More blastocysts are produced from fewer oocytes in ICSI  compared to IVF – results from a sibling oocytes study and definition of a new key performance indicator

Abstract

Background Which fertilization method, between ICSI and IVF in split insemination treatments, has the highest clinical efficiency in producing clinically usable blastocyst? Methods 211 infertile couples underwent split insemination treatments for a non-severe male factor. 1300 metaphase II (MII) oocytes were inseminated by conventional IVF and 1302 MII oocytes were micro-injected with the same partner’s semen. Embryo development until blastocyst stage on day V and clinical outcomes were valuated trough conventional key performance indicators (KPI), and new KPIs such as blastocyst rate per used MII oocytes and the number of MII oocytes to produce one clinically usable blastocyst from ICSI and IVF procedures. Results The results were globally analyzed and according to ovarian stimulation protocol, infertility indication, and female age. The conventional KPI were online with the expected values from consensus references. From global results, 2.3 MII oocyte was needed to produce one clinically usable blastocyst after ICSI compared to 2.9 MII oocytes in IVF. On the same way, more blastocysts for clinical use were produced from fewer MII oocytes in ICSI compared to IVF in all sub-groups. Conclusions In split insemination treatments, the yield of clinically usable blastocysts was always superior in ICSI compared to IVF. The new KPI "number of needed oocytes to produce one clinically usable embryo" tests the clinical efficiency of the IVF laboratory.

Effects of leukocytospermia on the outcomes of assisted reproductive technology

“…Tannus reported that ICSI does not have additional benefits in couples with advanced maternal age and without male factor infertility (Tannus et al, 2017), while Chamayou reported that more blastocysts are obtained from fewer oocytes in ICSI compared to IVF for non-severe male factor infertility (Chamayou et al, 2021). ICSI was more efficient in producing more embryos than IVF in the leukocytospermia group in our study.…”

“…However, the number of 2PN, available embryos and good‐quality embryos in ICSI was higher than that in IVF in our study, and whether the difference in split fertilization is related to semen optimization or to changing fertilization methods that further reduce the impact of WBC still needs more research. Tannus reported that ICSI does not have additional benefits in couples with advanced maternal age and without male factor infertility (Tannus et al, 2017), while Chamayou reported that more blastocysts are obtained from fewer oocytes in ICSI compared to IVF for non‐severe male factor infertility (Chamayou et al, 2021). ICSI was more efficient in producing more embryos than IVF in the leukocytospermia group in our study.…”

Impact of intracytoplasmic sperm injection in women with non-male factor infertility: A systematic review and meta-analysis

“…Twenty-six eligible literature were finally included according to the purpose of the study ( 4 – 29 ) of which six were randomized controlled studies ( 6 , 14 , 17 , 18 , 25 , 27 ) and 20 were retrospective cohort studies ( 4 , 5 , 7 – 13 , 15 , 16 , 19 – 24 , 26 , 28 , 29 ), Twenty-one English-language and five Chinese-language papers were included, and the literature was organized according to patient characteristics, patient numbers, study units, and primary outcome indicators. The basic characteristics of the collated literature are shown in Table 1 .…”

“…papers with fertilization rate outcome indicators supported by primary data were included according to the primary outcome indicators ( 3 – 6 , 10 , 16 , 20 , 24 , 26 , 28 ), and I 2 was used to detect heterogeneity, and the relative risk RR and 95% CI were calculated by including the primary data. The I 2 = 95%, I 2 > 50%, indicating a large heterogeneity among studies, so a random-effects model was adopted, and the results of the meta-analysis showed that the fertilization rate of the ICSI group was not statistically significant compared with the IVF group (RR = 0.90, 95% CI [0.90–1.09], P = 0.88, Figure 3A ).…”

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

“…Usually, post-treatment, 2 to 5 million motile spermatozoa/mL are recommended for c-IVF. However, the number of spermatozoa used for insemination of cumulus-intact oocytes during c-IVF differs between laboratories, ranging from 2 × 10 4 to 5 × 10 4 post-treatment motile spermatozoa in a final volume ranging from 20 μL to 1 mL [ 123 , 124 , 125 ]. Specific sperm kinematic factors are also taken into consideration when performing c-IVF.…”