Conventional in vitro fertilization (IVF) is as efficient as intracytoplasmic sperm injection (ICSI) in art cycles with low number of retrieved oocytes and normal sperm parameters

Abstract

ICSI was initially developed to treat male factor infertility and has significantly improved success rates of ART. Recently its application has been expanded to the cases of unexplained infertility, poor fertilization and low oocyte number without comprehensible evidence to support its use. The aim of this study was to investigate whether, in cases of low oocyte number with normal sperm parameters, the efficacy of ICSI is better than that of conventional IVF with respect to the rates of fertilization and pregnancy outcomes. Retrospective study. In total 288 cycles, number of retrieved oocytes was under five and semen analysis was normal parameters – ICSI and conventional IVF were performed in 229 and 59 cycles, respectively, from 2003 to 2005 in our hospital. All female partners were less than 38 years old. The rates of matured oocyte, fertilization, good embryo, clinical pregnancy, implantation, and delivery were examined between them. Total fertilization failure was evaluated to examine whether there is an increased risk of cancellation rate of embryo transfer (ET) in conventional IVF compared to that of ICSI. Chi square test and t-test were used for statistic analysis. There were no significant differences with respect to mean age of female partners, matured oocyte rate, fertilization rate, good embryo rate, and mean number of transferred embryo. Cancellation rate of ET due to total fertilization failure was not significantly different between two groups (9.1% for IVF vs. 11.3% for ICSI). Consequently, clinical pregnancy, implantation and delivery rates were similar between conventional IVF (28.0%, 18.6% and 16.0%) and ICSI groups (23.9%, 16.8% and 21.3%). Our results suggest that in ART cycles with low number of retrieved oocytes and normal semen parameters, conventional IVF is as efficient as ICSI with respect to fertilization rate and pregnancy outcomes.