Conventional IVF is as efficient as ICSI in ART cycles of poor responders with normal sperm parameters

Abstract

OBJECTIVE: In human ART cycles, poor ovarian response remains a significant problem as it is usually associated with high cancellation rates and low pregnancy rates. Because only a few oocytes can be retrieved from poor responders, total fertilization failure leading to cancellation of embryo transfer (ET) is one of main concerns for poor responders. Thus, ICSI has been generally recommended for the cycles with poor responder even if there is no obvious male factor. However, the effectiveness of ICSI for poor responders without male factors has not been clearly investigated. The aim of this study was to investigate whether the efficacy of ICSI is better than that of conventional IVF in ART cycles of poor responders with normal sperm parameters. DESIGN: Retrospective study. MATERIALS AND METHODS: In our study, poor responder was defined by the fact that the number of retrieved oocytes was ≤3. In total 405 cycles of poor responder without male factors from 2003 to 2006 in our hospital were evaluated. ICSI and convention IVF were performed in 340 and 65 cycles, respectively. All female partners were ≤ 40 years old. The rates of matured oocyte, fertilization, good embryo, implantation, clinical pregnancy, and delivery were examined. In addition, total fertilization failure was evaluated to examine whether there is an increased risk of ET cancellation rate in conventional IVF. Chi square test and t-test were used for statistic analysis. P values < 0.05 were considered significant. RESULTS: There were no significant differences between two groups with respect to mean age of female partner, rates of matured oocytes, fertilization, and good embryo, and mean number of transferred embryo. There were no differences in rates of clinical pregnancy, implantation and delivery between two groups. In addition, cancellation rate of ET due to total fertilization failure was not significantly different between two groups (9.2% for IVF vs. 12.4% for ICSI). CONCLUSIONS: Our results suggest that ART cycles of poor responders with normal semen parameters, conventional IVF is as efficient as ICSI with respect to fertilization rate, embryo development, and subsequent clinical outcomes.