P-229 Has rampant use of ICSI wiped out Conventional IVF for non male factor infertility, or can Conventional IVF hold its ground

Abstract

Abstract Study question Can ICSI completely replace and produce higher implantation rates as compared to conventional IVF for non-male factor infertility patients? Summary answer ICSI has no advantage over Conventional IVF in improving fertilization and implantation rates in non-male factor infertility. Rampant use of ICSI is not recommended. What is known already ICSI is the technique of choice for male factor infertility, no argument there. But in the recent times, the unbridled use of ICSI for non male factor patients worldwide has pushed Conventional IVF out of the picture. The evidence states otherwise, ICSI holds no significant advantage over Conventional IVF in couples with normal semen parameters when it comes to fertilization and implantation rates. The mechanical damage as a result of ICSI to oocytes cannot be ignored. Conventional IVF holds a certain advantage in allowing the oocyte to choose the sperm, mimicking in vivo selection. Study design, size, duration Prospective randomized study conducted in 140 patients, undergoing IVF & ICSI with non-male factor infertility. The oocytes recovered for all the patients included in the study underwent split insemination, and were divided into 2 groups: Group 1: Insemination by Conventional IVF, and Group 2: Insemination by ICSI. Fertilization and Implantation rates were recorded. Participants/materials, setting, methods 140 patients with non-male factor cause of infertility were undergoing IVF/ICSI cycle were included in this study. Post ovum pick-up, the oocytes recovered for each patient were split into 2 separate groups and inseminated using Conventional IVF (413) and ICSI (679). The fertilization check was done at 17±1 hours. The implantation rates were noted 14 days after embryo transfer using the beta HCG values. The results were noted and compared. Main results and the role of chance In the Conventional IVF(C-IVF) group, fertilization rates were 69.23% compared to 71.44% in the ICSI group. The implantation rates were 26.50% in C-IVF group vs 22.10% in ICSI group. Limitations, reasons for caution A major limitation is the time constraint which did not allow us to track the live birth rates along with the small sample size, the lack of data showing clinical outcomes of this study can be improved upon in the future and with similar studies. Wider implications of the findings While ICSI holds the gold standard as the technique of choice for male factor infertility, it is not superior to C-IVF in patients with normal semen parameters. ICSI for all cannot be justified at this moment. Larger RCTs are required to establish superiority of one technique over the other Trial registration number not applicable