Should ICSI be the treatment of choice for all cases of in-vitro conception?

Ola, Bolarinde; Afnan, Masoud; Sharif, Khaldoun; Papaioannou, Spyros; Hammadieh, Nahed; Barratt, Christopher L.R.

doi:10.1093/humrep/16.12.2485

Cited by 65 publications

(13 citation statements)

References 39 publications

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“…The fertilization rate for each couple was calculated as the percentage of oocytes fertilized. Fertilization rates were categorized into two groups (≤70% and >70%) and three groups, poor (0-40%), moderate (41-70%), and good (71-100%) [Ola et al 2001]. Similarly, progressive motility was categorized into three groups: poor (0-40%), moderate (41-70%), and good (71-100%) motility [Bonde et al 1998;Tesarik et al 2006].…”

Section: Discussionmentioning

confidence: 99%

Sperm DNA damage or progressive motility: which one is the better predictor of fertilizationin vitro?

Lee

Lewis

2011

Systems Biology in Reproductive Medicine

105

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Sperm progressive motility has been reported to be one of the key factors influencing in vitro fertilization rates. However, recent studies have shown that sperm DNA fragmentation is a more robust predictor of assisted reproductive outcomes including reduced fertilization rates, embryo quality, and pregnancy rates. This study aimed to compare the usefulness of sperm progressive motility and DNA damage as predictive tools of in vitro fertilization rates. Here, 136 couples provided 1,767 eggs with an overall fertilization rate of 64.2%. The fertilization rate in vitro correlated with both sperm progressive motility (r 2 = 0.236; P = 0.002) and DNA fragmentation (r 2 = −0.318; P < 0.001). The relative risk of a poor fertilization rate was 9.5 times higher in sperm of men with high DNA fragmentation (>40%) compared with 2.6 times in sperm with poor motility (<40%). Further, sperm DNA fragmentation gave a higher specificity (93.3%) in predicting the fertilization rate than progressive motility (77.8%). Finally, the odds ratio to determine fertilization rate (>70%) was 4.81 (1.89-12.65) using progressive motility compared with 24.18 (5.21-154.51) using DNA fragmentation. This study shows that fertilization rates are directly dependent upon both sperm progressive motility and DNA fragmentation, but sperm DNA fragmentation is a much stronger test.

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Section: Discussionmentioning

confidence: 99%

Sperm DNA damage or progressive motility: which one is the better predictor of fertilizationin vitro?

Lee

Lewis

2011

Systems Biology in Reproductive Medicine

105

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“…Taking cost into consideration, ICSI is a more expensive process (Ola et al, 2001). The application of ICSI usually results in more fertilization and available embryos, and therefore more infertile couples have the chance of embryo transfer.…”

Section: Discussionmentioning

confidence: 99%

Should few retrieved oocytes be as an indication for intracytoplasmic sperm injection?

Zhu

et al. 2012

J. Zhejiang Univ. Sci. B

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Abstract:Objective: To reevaluate whether relatively few oocytes obtained in one cycle are an indication for intracytoplasmic sperm injection (ICSI). Methods: A total of 406 cycles with three or fewer retrieved oocytes performed in 396 non-male infertile couples were retrospectively reviewed. Cycles were classified into three groups by different fertilization techniques: the in vitro fertilization (IVF) group, insemination with conventional IVF; the ICSI group, insemination with ICSI though semen parameters were normal; and the rescue ICSI group, re-insemination with ICSI after conventional IVF failure. Results: The ICSI group resulted in higher normal fertilization compared with the conventional IVF group. Correspondingly, the cycle cancellation rate was decreased in the ICSI group, though it was not statistically significant. The clinical pregnancy rate and implantation rate were lower in the ICSI group compared with the conventional IVF group. Rescue ICSI was a method to avert total fertilization failure in conventional IVF, increasing fertilization and ensuring embryo availability for transfer, but the normal fertilization was the lowest due to delayed insemination and the chance of pregnancy was very little. Conclusions: Obtaining only few oocytes in one cycle is not considered as an indication for ICSI when the sperm sample is apparently normal. Rescue ICSI is either not recommended if conventional insemination fails. Such patients should not be subjected to the unnecessary costs and potential risks of ICSI.

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“…In the ICSI procedure, there is no such selection, and "forced fertilization" can be achieved using spermatozoa that might never have attained natural fertilization. It has been shown that spermatozoa from infertile men have higher rates of defects such as DNA damage [16,17] and aneuploidy [18][19][20], which are likely to have an adverse effect on embryo development [21] and thereby decrease embryo quality. These findings were not true for grade A embryos, probably due to the small sample size.…”

Section: Discussionmentioning

confidence: 99%

Comparison of embryo quality between intracytoplasmic sperm injection and in vitro fertilization in sibling oocytes

Yoeli

Orvieto

Ashkenazi

et al. 2008

J Assist Reprod Genet

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Background The aim of the present study was to compare the quality of embryos derived from sibling oocytes by in vitro fertilization (IVF) or ICSI. Methods Consecutive patients with a less than 40% fertilization rate in a previous standard IVF cycle or with relative male factor infertility were recruited for the study. The oocytes retrieved from each patient were divided into two groups for either conventional insemination (group A) or ICSI (group B). Power analysis showed that to detect a 25% difference in the rate of high-quality embryos between the groups with a power of 0.8, at least 1,200 oocytes were needed in each group. Results One hundred seventy-seven patients were included in the study. Group A was comprised of 1,526 oocytes and group B of 1,480 sibling oocytes. As expected, the fertilization rate was significantly higher in group B than group A (67.1 vs. 43.6%, p < 0.001). No significant between-group differences were observed in cleavage rate (92.7 and 89.7%, respectively) and the rate of either grade A embryos (22.6 and 23.9%, respectively) or grade A 1 embryos (37.3 and 33.5%, respectively).However, in the subgroup of patients with relative malefactor infertility (n=36), the rate of grade A 1 embryos was significantly higher in the IVF than the ICSI group (46.4 vs. 29.0%, respectively, p=0.02). Conclusions Embryo quality does not seem to be influenced by the mode of fertilization (IVF or ICSI). We assume that embryo quality depends on intrinsic factors of the gametes involved rather than on the fertilization process per se.

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Should ICSI be the treatment of choice for all cases of in-vitro conception?

Cited by 65 publications

References 39 publications

Sperm DNA damage or progressive motility: which one is the better predictor of fertilizationin vitro?

Sperm DNA damage or progressive motility: which one is the better predictor of fertilizationin vitro?

Should few retrieved oocytes be as an indication for intracytoplasmic sperm injection?

Comparison of embryo quality between intracytoplasmic sperm injection and in vitro fertilization in sibling oocytes

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