Authors’ response: polarization microscopy and rescue ICSI

Abstract

1 h We thank Dr Coticchio for his commentary on our article ‘Spindle examination in unfertilized eggs using the polarization microscope can assist rescue ICS’. His view on some key points in our study harmonize with ideas and issues we have discussed and debated over and over. Therefore, we are pleased to be able to highlight answers for issues he has raised. First, we know the issue of whether to perform rescue intracytoplasmic sperm injection (ICSI) or to cancel the current cycle is still under debate. The goal of assisted reproductive technology is to help infertile couples have a healthy baby, not increase the number of transferable embryos of compromised quality. The biological and clinical implications of oocyte ageing are well reported in numerous articles, including cytogenetic abnormalities in the resulting embryo following rescue ICSI (Morton et al., 1997; Pehlivan et al., 2004) as well as congenital abnormalities (Tarin et al., 2002). However, we should also consider that routine ICSI and IVF might also cause an increased risk of major congenital anomalies compared with natural conception (Wen et al., 2012). To our knowledge, there have been reports of successful births following rescue ICSI (Yuzpe et al., 2000; Shalom-PAZ et al., 2011). As previously shown from data in our centre (Shalom-PAZ et al., 2011), out of 20 pregnancies, only one was diagnosed with trisomy 21 and was terminated, while the other children were found to be