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Should Intra Cytoplasmic Sperm Injection (ICSI) be the primary insemination method in women undergoing IVF cycles with donor sperm?

  • Gynecologic Endocrinology and Reproductive Medicine
  • Published:
Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

Abstract

Purpose

To compare efficacy of Intra Cytoplasmic Sperm Injection (ICSI) with conventional in vitro fertilization (IVF) on treatment outcome in women undergoing in vitro fertilization with donor sperm.

Methods

We examined retrospectively the outcome data from 203 patients undergoing fresh cycles of conventional IVF (cIVF) or ICSI and an additional 77 frozen-thawed embryo transfer (FET) cycles during 2003–2014, all using donor sperm. Fertilization, cleavage, pregnancy and live birth rates and number of high-quality embryos were compared between cIVF and ICSI.

Results

Altogether 185 women underwent 479 transfer cycles of fresh embryos (237 cIVF vs. 224 ICSI and 18 “rescue ICSI” cycles). In addition, 77 FET cycles were compared (24 cIVF vs. 53 ICSI cycles). No differences were found between cIVF and ICSI in fertilization, cleavage, pregnancy and live birth rates (92.6% vs 92.2%, 73.4% vs 72.4%, 25.3% vs 27.2% and 13.1% vs 14.7%, respectively). Pregnancy and life birth rates remained similar even when FET cycles were included (25.8% vs 26.2% and 13.1% vs 13.7%, respectively). The use of ICSI was associated with lower rates of high-quality embryos (52.7% vs. 63.3%, P < 0.0001). A multivariate logistic regression analysis found that patients’ age, number of transferred embryos and smoking were independently associated with the chance to conceive. Patient age correlated inversely with fertilization rate (r = − 0.13, P < 0.006).Non-smokers were more likely to become pregnant (OR = 2.23, P < 0.012).

Conclusions

Our results show that ICSI does not bypass the age-related decrease in oocyte quality in patients using donor sperm for IVF. Use of ICSI was associated with lower rates of high-quality embryos. The findings imply that ICSI should not be the primary method of insemination in patients undergoing IVF with donor sperm.

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All data and study materials are available if needed.

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The study was not founded.

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Authors and Affiliations

  1. Fertility and IVF Unit, Department of Obstetrics and Gynecology, Lady Davis Carmel Medical Center and the Ruth and Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, 7 Michal Sreet, Haifa, Israel

    Zofnat Wiener-Megnazi, Assaf Dori, Hadar Gluska, Shirly Lahav-Baratz, Idit Blais, Mara Koifman & Martha Dirnfeld

Authors
  1. Zofnat Wiener-Megnazi
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  2. Assaf Dori
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  3. Hadar Gluska
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  4. Shirly Lahav-Baratz
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  5. Idit Blais
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  6. Mara Koifman
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  7. Martha Dirnfeld
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Contributions

ZW-M: Conception and design of the manuscript, Critical revision of the manuscript for important intellectual content. AD: Acquisition of data, Statistical analysis. HG: Critical revision of the manuscript for important intellectual content. SL-B: Analysis and Interpretation of data. IB: Analysis and Interpretation of data. MK: Analysis and Interpretation of data. MD: Supervision.

Corresponding author

Correspondence to Zofnat Wiener-Megnazi.

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The authors declare that they have no conflict of interest.

Ethical approval

The study was approved on 28.1.2014 by the institutional ethical review board. IRB number 0074–13-CMC.

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Wiener-Megnazi, Z., Dori, A., Gluska, H. et al. Should Intra Cytoplasmic Sperm Injection (ICSI) be the primary insemination method in women undergoing IVF cycles with donor sperm?. Arch Gynecol Obstet 306, 1245–1251 (2022). https://doi.org/10.1007/s00404-022-06571-8

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  • DOI: https://doi.org/10.1007/s00404-022-06571-8

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