Conventional in-vitro fertilization versus intracytoplasmic sperm injection in sibling oocytes from couples with tubal infertility and normozoospermic semen
C. Staessen et al., Conventional in-vitro fertilization versus intracytoplasmic sperm injection in sibling oocytes from couples with tubal infertility and normozoospermic semen, HUM REPR, 14(10), 1999, pp. 2474-2479
An auto-controlled study was conducted in couples with tubal infertility an
d normozoospermic semen. The fertilization rates and embryonic development
in sibling oocytes treated, using the same semen sample, either by conventi
onal in-vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI
) at the same time were compared. Sibling oocyte-cumulus complexes (OCC) of
56 different couples with tubal infertility and normozoospermic semen were
randomly divided in order of retrieval into two groups inseminated either
by conventional IVF or by ICSI, Of the retrieved OCC in the same cohort, 53
.0 +/- 31.2 and 62.0 +/- 26.6% showed two distinct pronuclei after conventi
onal IVF and ICSI respectively (not significant). Complete fertilization fa
ilure occurred after conventional IVF in 12.5% (7/56 couples). After ICSI,
the comparable figure was 3.6% (2/56), The number of cases was too small to
apply a statistical test to this difference. Total cleavage rates were qui
te similar: 86.7 +/- 28.0 and 90.1 +/- 21% of the zygotes developed into tr
ansferable embryos after IVF and ICSI respectively (not significant). Simil
arly, no difference in embryo quality was observed. Although injection and
insemination of the oocytes were performed at the same time in the two grou
ps, at 42 h post-insemination more embryos were at the four-cell stage afte
r ICSI (P < 0.001) than after conventional IVF, where more embryos were sti
ll at the two-cell stage (P < 0.02). Embryo transfer was possible in all 56
couples, resulting in 16 positive serum human chorionic gonadotrophin test
s (28.6% per embryo transfer), from which a clinical pregnancy resulted in
15 couples. The best embryos were selected for transfer independently of th
e insemination procedure, but preferably from the same origin. There appear
ed to be no difference in implantation potency of the embryos obtained with
either technique after the non-randomized transfers.