P-146: Intracytoplasmic sperm injection (ICSI) versus In vitro fertilization (IVF): Is there a higher incidence of unfavorable outcome with either?

Abstract

To compare the rate of unfavorable outcomes recorded in ICSI patients versus IVF patients at the Colorado Center for Reproductive Medicine, and to determine if this rate differs significantly from each other and from the national average of birth defects reported by the Center for Disease control Retrospective data analysis from January 2000 to December 2004. Data was reviewed for all patients who had either all ICSI or all IVF from 2000-2004. Patients ranged in age from 21 to 50 and were undergoing either donor or non-donor cycles. Criteria for being included in the analysis were: cycles must consist solely of either ICSI or IVF, cycle must have been a fresh cycle (no frozen embryo transfers), and patients must have had only a single intrauterine gestation. Unfavorable outcomes include major and minor birth defects, chromosomal abnormalities, still birth, therapeutic abortion and miscarriage. A chi square test was used to determine significance. Of the 1189 cycles that were analyzed: There were 700 cycles which were all ICSI and 489 cycles which were all IVF. Of the ICSI cycles, there were nine patients that reported defects, five patients who reported stillbirths and 5 patients who had therapeutic abortions (TAB), resulting in a 2.7% rate of abnormalities associated with the ICSI cycles. Of the IVF cycles, there were seven patients that reported defects, no patients reporting stillbirths and 3 patients who had TAB, resulting in a 2.0% rate of abnormalities associated with the IVF cycles. The difference between the groups is not statistically significant. The national average for birth defects reported from the Center for Disease Control is around 1 in every 33 babies or about 3.0%. In the ICSI group, there were 112 miscarriages (MAB) reported (16.0%). In the IVF group, there were 57 MAB reported (11.7%). Again, the difference was not significant and not dissimilar to the national average MAB rate (15%). Some studies have shown that ICSI patients have a statistically higher incidence of birth defects when compared to IVF patients or the general population. There have also been other studies that have refuted these findings, and did not find that there was any statistically significant difference between ICSI patients, IVF patients, and the general population. Based upon our results, we conclude that, at the Colorado Center for Reproductive Medicine there is not a higher incidence of unfavorable outcomes with either ICSI or IVF. The data suggests that patients receiving ICSI at CCRM do not have an increased chance of unfavorable outcome.