Does embryo ploidy status differ in patients whose eggs were fertilized by standard insemination versus intra cytoplasmic sperm injection (ICSI)?

Abstract

To determine if standard insemination technique versus ICSI leads to measurable differences in embryonic chromosomal status. Retrospective analysis. 26 patients undergoing ovarian stimulation/pre-gestational screening protocols at our center from 2013-2014 were included. Patients were only included if they underwent both standard insemination and ICSI within a single egg retrieval cycle, thus patients served as their own controls. Primary outcomes included fertilization rates, number of embryos that reached an appropriate stage (2Bc or greater) for trophoectoderm biopsy (TEBx) and number of euploid embryos. T-tests of means and paired t-tests were used for statistical analysis. Average age of the patients in this study was 35.6 years +/- 5.2. Average day 2 estradiol (pg/ml) and follicle stimulating hormone (mIU/ml) values were 55.1 +/-56.5 and 6.75 +/- 2.87. Average total gonadotropin dosage (IU) and estradiol at trigger were 3648.6 +/- 144.6 and 2789 +/- 1418.3, respectively. Approximately 19.8 +/- 9.3 oocytes on average were retrieved with a maturation percentage of 81%. Insemination fertilization rates were 69% +/- 23.8 and 75% +/- 13.8 (p-value of 0.28) for the ICSI cohort. The percentage of embryos available for TEBx for the insemination cohort was 32% and 38% for the ICSI cohort, with a p-value of 0.15 and RR 0.84 (0.652-1.07). 52.8% of embryos biopsied resulting from ICSI and 47% of embryos from standard insemination were euploid, and paired t-test analysis showed no significance between the two groups, p = 0.07. Standard insemination techniques and ICSI showed no difference in fertilization rates, and no difference in percent of chromosomally competent embryos. In the absence of standard indications for ICSI, there does not appear to be any benefit or harm in the use of ICSI for increased development of chromosomally competent embryos.