IVF vs. ICSI in cycles excluding the male factor infertility. experience of the institute of reproductive medicine.
DOI:
https://doi.org/10.37800/RM.1.2022.23-35Keywords:
assisted reproductive technologies, infertility factor, intracytoplasmic injection (ICSI), in vitro fertilization (IVF), obstetric complications, pregnancy outcomesAbstract
Relevance: Intracytoplasmic sperm injection (ICSI) has been introduced into the clinical practice of assisted reproductive technologies (ART) as a treatment for patients with male factor infertility. Nowadays, there is no scientific consensus regarding the benefits of ICSI compared to standard IVF in non-male factor infertility cycles. Also, there is conflicting data on the effect of the fertilization method on the course and outcomes of pregnancies.
The study aimed to determine the effectiveness of ART programs after fertilization by ICSI in non-male factor infertility cycles and establish the effect of this insemination method on pregnancy outcomes.
Methods: We analyzed the results of 2505 fresh IVF/ICSI cycles with non-male factor infertility and 340 medical records of pregnancies in patientstreated from 2012 to 2018 at the Institute of Reproductive Medicine (Almaty, Kazakhstan) to compare their effectiveness. The study cohortwas divided into two age categories: below 35 and above 35 years of age.
Results:The performed analysis have shown a significant increase in the fertilization rate (FR) after ICSI compared to IVF in both female age categories (‘below the age of 35’: 82.36 vs. 68.43%, ‘above the age of 35’ – 80.7 vs. 67.68 %, respectively (p<0.001)). The data demonstrated there was no statistical difference (p>0.05) in the clinical pregnancy rate (CPR) between IVF and ICSI in both female age categories (‘below the age of 35’ – 46.02 vs. 50.62%, ‘above the age of 35’ – 44.1 vs. 43.05%, in IVF vs. ICSI, respectively). In addition, there was no statistical difference (p>0.05) in the live birth rate in both female age categories (‘below the age of 35’ – 32.54 vs. 33.62%, ‘above the age of 35’ – 24.88 vs. 28.31%, in IVF vs. ICSI, respectively). It was also noted that in pregnancies resulting from non-male factor ICSI cycles, patients significantly more frequently (p≤0.05) experience natal complications such as low birth weight and fetal growth retardation (FGR).
Conclusion: In non-male factor cycles, the ICSI method increases the fertilization rate but does not affect the outcome of the ART cycle. We recommend reconsidering the routine use of ICSI in patients with non-male factor infertility and other indications for ICSI.In our study, the risks of fetal growth retardation or/and low birth weight were increased in pregnancies resulting from the ICSI cycle compared to women who achieved pregnancy after an IVF cycle.
References
Pereira N., Palermo G. Intracytoplasmic sperm injection. Indications, Techniques and Applications. / ed. G.D. Palermo, E.S.Sills. –1st ed. – Springer, Cham, 2018. – P. 9-14. https://doi.org/10.1007/978-3-319-70497-5.
Wyns C., Gliozheni O., Hambartsoumian E., Strohmer H., Petrovskaya E., Tishkevich O., Bogaerts K., Wyns C., Balic D., Antonova I., Pelekanos M., Rezabek K., Markova J., Lemmen J., Sõritsa D., Gissler M., Pelkonen S., Pessione F., De Mouzon J., Tandler A., Kalantaridou S., Urbancsek J., Kosztolanyi G., Bjorgvinsson H., Mocanu E., Cloherty J., Scaravelli G., De Luca R., Lokshin V., Karibayeva S., Magomedova V., Bausyte R., Masliukaite I., Schilling C., Calleja-Agius J., Moshin V., Motrenko Simic T., Vukicevic D., Smeenk J. M. J., Petanovski Z., Romundstad L.B., Janicka A., Calhaz-Jorge C., Mesquita Guimaraes J. M., Laranjeira A. R., Rugescu I., Doroftei B., Korsak V., Radunovic N., Tabs N., Virant-Klun I., Saiz I.C., Prados Mondéjar F., Bergh C., Weder M., Buttarelli M., Primi M., Ryan H., Baranowski R., Gryshchenko M., Bergh C., Calhaz-Jorge C., De Geyter C., Kupka M.S., Motrenko T., Rugescu I., Smeenk J., Tandler-Schneider A., Vidakovic S., Goossens V. ART in Europe, 2016: results generated from European registries by ESHRE // Hum. Reprod. Open. – 2020. – Vol. 2020(3). – P. 1-17. https://doi.org/10.1093/hropen/hoaa032.
Adamson G.D., ZegersF., de Mouzon J., Ishihara O., Dyer S., Banker M., Chambers G., Kupka M. ICMART Preliminary World Report 2017. – June 26-July 1, 2021. – P.5. https://www.icmartivf.org/wp-content/uploads/ICMART-ESHRE-WR2017-Preliminary.pdf.
Krog M., Prior M., Carlsen E., Loft, A., Forman J., Pinborg A., Andersen A. N. Fertilization failure after IVF in 304 couples – A case-control study on predictors and long-term prognosis // Eur. J. Obstet. Gynecol. Reprod. Biol. – 2015. – Vol. 184. – P. 32-37. http://dx.doi.org/10.1016/j.ejogrb.2014.10.037.
Abbas A.M., Hussein R.S., ElsenityM.A., Samaha I.I., El Etriby K.A., Abd El-Ghany M.F., Khalifa M.A., Abdelrheem S.S., Ahmed A.A., Khodry M.M. Higher clinical pregnancy rate with in-vitro fertilization versus intracytoplasmic sperm injection in treatment of non-male factor infertility: Systematic review and meta-analysis // J. Gynecol. Obstet. Hum. Reprod. – 2020. – Vol. 49(6). – P. 1010706. http://dx.doi.org/10.1016/j.jogoh.2020.101706.
Johnson L.N., Sasson I.E., Sammel M.D., Dokras A. Does intracytoplasmic sperm injection improve the fertilization rate and decrease the total fertilization failure rate in couples with well-defined unexplained infertility? A systematic review and meta-analysis // Fertil. Steril. – 2013. – Vol. 100(3). – P. 704-711. http://dx.doi.org/10.1016/j.fertnstert.2013.04.038.
Yovich J.L., Conceicao J.L., Marjanovich N., Ye Y., Hinchliffe P.M., Dhaliwal S.S. Keane K.N. An ICSI rate of 90% minimizes complete failed fertilization and provides satisfactory implantation rates without elevating fetal abnormalities // Reprod. Biol. – 2018. - Vol. 18(3). – P. 301-311. https://doi.org/10.1016/j.repbio.2018.05.002.
Boulet S.L., Mehta A., Kissin D.M., Warner L., Kawwass J.F., Jamieson D.J. Trends in Use of and Reproductive Outcomes Associated With Intracytoplasmic Sperm Injection // JAMA. – 2015. – Vol. 313(3). – P. 255. https://doi.org/10.1001/jama.2014.17985.
Schwarze J., Jeria R., Crosby J., Villa S., Ortega C., Pommer R. Is there a reason to perform ICSI in the absence of male factor? Lessons from the Latin American Registry of ART // Hum.Reprod. Open. – 2017. – Vol. 2017(2). – P. 1-5. https://doi.org/10.1093/hropen/hox013.
Sustar K., Rozen G., Agresta F., Polyakov A. Use of intracytoplasmic sperm injection (ICSI) in normospermic men may result in lower clinical pregnancy and live birth rates // Austral. New Zeal. J. Obstet. Gynaecol. – 2019. – Vol. 59(5). – P. 706-711. https://doi.org/10.1111/ajo.13004.
Supramaniam P.R., Granne I., Ohuma E.O., Lim L.N., Mcveigh E., Venkatakrishnan R., Becker C.M., Mittal M. ICSI does not improve reproductive outcomes in autologous ovarian response cycles with non-male factor subfertility // Hum. Reprod. – 2020. – Vol. 35(3). – P. 583-594. https://doi.org/10.1093/humrep/dez301.
Pinborg A., Wennerholm U.B., Romundstad L.B., Loft A., Aittomaki K., Söderström-Anttila V., Nygren K.G., Hazekamp J., Bergh C. Why do singletons conceived after assisted reproduction technology have an adverse perinatal outcome? Systematic review and meta-analysis // Hum. Reprod.Upd. – 2013. – Vol.19. – P. 87-104. https://doi.org/10.1093/humupd/dms044.
Sullivan-PykeC.S., Senapati S., Mainigi M.A., Barnhart K.T. In vitro fertilization and adverse obstetric and perinatal outcomes // Seminars Perinatol. – 2017 – Vol.41(6). – S. 345-353. DOI: https://doi.org/10.1053/j.semperi.2017.07.001.
Kamath M.S., Kirubakaran R., Mascarenhas M., Sunkara S.K. Perinatal outcomes after stimulated versus natural cycle IVF: a systematic review and meta-analysis. // Reprod. BioMed. Online. – 2018 – Vol.36(1). – P. 94-101. https://doi.org/10.1016/j.rbmo.2017.09.009.
Nouri K., Ott, J., Stoegbauer L., Pietrowski D., Frantal S., Walch, K. Obstetric and perinatal outcomes in IVF versus ICSI-conceived pregnancies at a tertiary care center - a pilot study // Reprod. Biol. Endocrinol. – 2013. – Vol. 11(1). – P. 1-6. https://doi.org/10.1186/1477-7827-11-84.
Dieke A.C., Mehta A., Kissin D.M., Nangia A.K., Warner L., Boulet S.L. Intracytoplasmic sperm injection use in states with and without insurance coverage mandates for infertility treatment, United States, 2000–2015 // Fertil.Steril. – 2018. – Vol. 109(4). – P. 691-697. https://doi.org/10.1016/j.fertnstert.2017.12.027.
Dyer S., Chambers G., De Mouzon J., Nygren K., Zegers-Hochschild F., Mansour R., Ishihara O., Banker M., Adamson G. International Committee for Monitoring Assisted Reproductive Technologies world report: Assisted Reproductive Technology 2008, 2009 and 2010 // Hum. Reprod. – 2016. – Vol. 31(7). – P. 1588-1609. https://doi.org/10.1093/humrep/dew082.
The Vienna consensus: report of an expert meeting on the development of ART laboratory performance indicators // Reprod. BioMed. Online. – 2017. – Vol. 35(5). – P. 494-510. http://dx.doi.org/10.1016/j.rbmo.2017.06.015.
Balaban B., Brison D., Calderon G., Catt J., Conaghan J., Cowan L., Ebner T., Gardner D., Hardarson T., Lundin K., Cristina Magli M., Mortimer D., Mortimer S., Munne S., Royere D., Scott L., Smitz J., Thornhill A., Van Blerkom J., Van Den Abbeel E. The Istanbul consensus workshop on embryo assessment: proceedings of an expert meeting // Hum.Reprod. – 2011. – Vol. 26(6). – P. 1270-1283. https://doi.org/10.1093/humrep/der037.
Farhi J., Cohen K., Mizrachi Y., Weissman A., Raziel A., Orvieto R., Should ICSI be implemented during IVF to all advanced-age patients with non-male factor subfertility? // Reprod. Biol. Endocrinol. – 2019. – Vol. 17(1). – P. 1-5. https://doi.org/10.1186/s12958-019-0474-y.
Wang C., Buyalos R., Hubert G., Shamonki M., Blastocyst euploidy rates are not affected by intracytoplasmic sperm injection (ICSI) versus conventional insemination // Fertil. Steril. – 2021. – Vol. 116(3). – P. e144. https://doi.org/10.1016/j.fertnstert.2021.07.400.
Neri Q., Rosenwaks Z., Palermo G. To ICSI or Not to ICSI // Seminars Reprod. Med. – 2015. – Vol. 33(02). – P. 092-102. http://dx.doi.org/10.1055/s-0035-1546825.
Haas J., Miller T. E., Nahum R., Aizer A., Kirshenbaum M., Zilberberg E., Lebovitz O., Orvieto R. The role of ICSI vs. conventional IVF for patients with advanced maternal age—a randomized controlled trial // J. Assist. Reprod. Genet. – 2020. – Vol. 38(1). – P. 95-100. https://doi.org/10.1007/s10815-020-01990-5.
Drakopoulos P., Garcia-Velasco J., Bosch E., Blockeel C., De Vos M., Santos-Ribeiro S., Makrigiannakis A., Tournaye H., Polyzos N. P. ICSI does not offer any benefit over conventional IVF across different ovarian response categories in non-male factor infertility: a European multicenter analysis // J. Assist. Reprod. Genet. – 2019. – Vol. 36(10). – P. 2067-2076. https://doi.org/10.1007/s10815-019-01563-1.
Practice Committees of the American Society for Reproductive Medicine and the Society for Assisted Reproductive Technology. Intracytoplasmic sperm injection (ICSI) for non–male factor indications: a committee opinion // Fertil. Steril. – 2020. – Vol. 114(2). – P. 239-245. https://doi.org/10.1016/j.fertnstert.2020.05.032.
Подзолкова Н.М., Скворцова М.Ю., Прилуцкая С.Г. Беременность после ЭКО: факторы риска развития акушерских осложнений // Проблемы репродукции. – 2020 – T.26, № 2. – С. 120-131. [Podzolkova N.M., Skvorcova M.Yu., Priluckaya S.G. Beremennost' posle E'KO: faktory riska razvitiya akusherskix oslozhnenij // Problemy reprodukcii. – 2020. – T.26 №2. – S. 120-131. (in Russ.)]. https://doi.org/10.17116/repro202026021120.
Кешишян Е. С., Царегородцев А. Д., Зиборова М. И. Состояние здоровья и развитие детей, рожденных после экстракорпорального оплодотворения // Российский вестник перинатологии и педиатрии. – 2014 – Т. 59, №5. – С. 15-25. [[Keshishyan E.S., Tsaregorodtsev A.D., Ziborova M.I. Sostoyanie zdorov'ya i razvitie detej, rozhdennyh posle ekstrakorporal'nogo oplodotvoreniya // Rossijskij vestnik perinatologii i pediatrii. – 2014. - T.59, №5. - S. 15-22 (in Russ.)]. https://www.ped-perinatology.ru/jour/article/view/230.
Whitelaw N., Bhattacharya S., Hoad G., Horgan G. W., Hamilton M. and Haggarty P. Epigenetic status in the offspring of spontaneous and assisted conception // Hum.Reprod. – 2014. – Vol. 29(7). – P. 1452-1458. https://doi.org/10.1093/humrep/deu094.
Bouillon C., Fauque P. [Follow-up of children conceived by assisted reproductive technologies (in French)]// Archives de Pédiatrie. – 2013. - Vol. 20(5). – P. 575-579. https://doi.org/10.1016/j.arcped.2013.02.003.
Simpson J. Birth defects and assisted reproductive technologies // Seminars Fetal Neonatal Med. – 2014. – Vol. 19(3). – P. 177-182. https://doi.org/10.1016/j.siny.2014.01.001.
Jaques A.M., Amor D.J., Baker H.G., Healy D.L., Ukoumunne O. C., Breheny S., Garrett C., Halliday J.L. Adverse obstetric and perinatal outcomes in subfertile women conceiving without assisted reproductive technologies // Fertil.Steril. – 2010. – Vol. 94(7). – P. 2674-2679. https://doi.org/10.1016/j.fertnstert.2010.02.043.
Rimm A.A., Katayama A.C., Katayama K.P. A meta-analysis of the impact of IVF and ICSI on major malformations after adjusting for the effect of subfertility // J. Assist. Reprod. Genet. – 2011. – Vol. 28(8). – P. 699-705. https://doi.org/10.1007/s10815-011-9583-z.
Additional Files
Published
How to Cite
Issue
Section
License
The articles published in this Journal are licensed under the CC BY-NC-ND 4.0 (Creative Commons Attribution – Non-Commercial – No Derivatives 4.0 International) license, which provides for their non-commercial use only. Under this license, users have the right to copy and distribute the material in copyright but are not permitted to modify or use it for commercial purposes. Full details on the licensing are available at https://creativecommons.org/licenses/by-nc-nd/4.0/.
