Conventional oocyte insemination may result in a better pregnancy outcome than intracytoplasmic sperm injection (ICSI) for unexplained infertility.
ABSTRACT To determine in cases of unexplained infertility whether conventional oocyte insemination vs. intracytoplasmic sperm injection results in differences in fertilization rates, frequency of failed fertilization, clinical and live delivered pregnancy rates, and implantation rates.
Retrospective evaluation of these parameters in couples undergoing in vitro fertilization embryo transfer (IVF-ET) (minimum 2 embryos) in women with unexplained infertility over a 7-year period.
There was a significantly higher fertilization rate (p < .001) with ICSI vs. conventional insemination (73.7% vs. 63.7%). However of greater clinical importance, the clinical and live delivered pregnancy rates were significantly higher with conventional insemination (52.7% and 46.2%) than with ICSI 33.6% and 29.0%. The implantation rates were also significantly higher with conventional oocyte insemination (24.9% vs. 17.8%). Failed fertilization was low in both groups.
The process of ICSI, whether it involves possible subtle oocyte damage by the procedure or the andrologist not choosing the ideal sperm, may lead to embryos that are less hearty despite their normal appearance.
- SourceAvailable from: Adrian Shulman[Show abstract] [Hide abstract]
ABSTRACT: Total motile count (TMC) is a useful tool for sperm evaluation, comprising both quantitative and motility parameters. Although frequently used, TMC has not yet been evaluated as a contributory variable for intracytoplasmic sperm injection (ICSI) cycles. In this study we evaluate the possible role of TMC as a prognostic parameter in cycles designated for ICSI. We also test the existence of a possible TMC-threshold value that might be predictive for ICSI cycle outcome in the everyday practice. This is a retrospective cohort study in which the research question is addressed by a locally weighted regression (LOESS) analysis. Primary outcome measures are fertilization rate, good quality embryos rate and implantation rate. A total of 666 patients were included, contributing 1456 cycles. The effect of TMC over the fertilization rate was significant, depicting an inverted U-shaped curve: with up to approximately 10 million motile sperm, fertilization rates increased as TMC increased, but from this point on decreased. A slight increment in the rate of good embryo formation with increasing value of TMC was noted, but this did not reach a statistical significance. TMC values demonstrated no effect in the case of implantation rates. ICSI may offer an advantage related to fertilization rates for the sub-fertile male population, with a motile sperm count up to 10 million.International Journal of Molecular Epidemiology and Genetics 01/2012; 3(3):205-12.
- [Show abstract] [Hide abstract]
ABSTRACT: To present an estimation of the pregnancy rate after IVF or intracytoplasmic sperm injection stratified by blastocyst morphology and age. Retrospective analysis. Private IVF clinic. A total of 1,488 single frozen-thawed blastocyst transfer cycles. All frozen-thawed blastocysts used in the study were obtained in the patients' first oocytes retrieval cycles. Clinical pregnancy rate (CPR), viable pregnancy rate (VPR), and delivery rate (DR) according to blastocyst morphological score (Gardner and Schoolcraft score) in three different age groups: women aged 22-33 years, 34-37 years, and 38-45 years. The quality of blastocysts degraded as age group increased. The proportions of good-quality blastocysts (grades 4 and above) were 62.3%, 56.3%, and 41.1% in age groups of 22-33 years, 34-37 years, and 38-45 years. Within the same blastocyst quality, CPR, VPR, and DR tended to be lower with increased age. Chances of pregnancy were reduced by 60% or more for women 38 years and older with blastocyst morphology of grades 1 and 2. Significant trends were observed for both age and blastocyst morphology groups. There was a significant correlation between blastocyst quality and CPR, VPR, and DR in addition to the influence of age on the three rates. The findings may help predict successful pregnancy in single-blastocyst transfer.Fertility and sterility 03/2011; 95(3):948-52. · 3.97 Impact Factor
- [Show abstract] [Hide abstract]
ABSTRACT: There are three kinds of infertility treatment: medical treatment, surgical treatment and assisted reproductive technology (ART). ART includes intra uterine insemination (IUI), in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI). ART technologies made a lot of progress last years and their field of applications extended. Through literature reviews, IUI is recommended for unexplained infertility and discussed for male or cervical infertility. IVF is recommended for tubal and unexplained infertility. Limits between IVF and ICSI in case of male infertility remains unclear. In non mal infertility ICSI is not recommended.Journal de Gynécologie Obstétrique et Biologie de la Reproduction 12/2010; 39(8 Suppl 2):S88-99. · 0.45 Impact Factor