Abstract
Research questionDoes the application of delayed intracytoplasmic sperm injection (DICSI) in late maturing oocytes have the potential to improve fertilisation, blastocyst formation, pregnancy, and live birth rates for poor prognosis patients? DesignRetrospective analysis of 2,243 oocytes collected from 250 poor prognosis patients that underwent 311 ART cycles. Patients were offered DICSI when: over 50% of oocytes collected were immature on Day 0, fewer than 50% of the injected oocytes were fertilised on Day 1 or when patients were undergoing PGT-A with a view to increase the number of embryos available for testing. ResultsFertilisation and blastulation rates differed depending on the original assessment of the oocyte maturation stage. Euploidy rate did not however differ between blastocysts derived from fertilised oocytes originally assessed as MI or MII, and a transferred blastocyst derived from a matured oocyte originally assessed as MI was as likely to result in a live birth as one derived from an MII oocyte. For births to date, no differences between intracytoclasmic sperm injection and DICSI were observed in delivery method, gestation period or birth weight. As a result of DICSI, at least 27 cycles (8.7%), which would have otherwise been unproductive resulted in live births with a further five ongoing pregnancies. ConclusionsMI and GV oocytes can both complete maturation in vitro. The blastocysts produced from fertilisation of these oocytes appear to be as likely to be chromosomally normal as their counterparts and to result in similar live birth rates as blastocysts derived from oocytes originally assessed as MII. With no evident differences in birth outcomes and DICSI apparently increasing overall ART cycle success, this approach is shown to have value for poor prognosis patients.
Published Version
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