Effect of ICSI on subsequent blastocyst development and pregnancy rates (original) (raw)
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Fertility and Sterility, 2005
Objective: To compare the quality of early cleaving embryos and blastocysts obtained by IVF or intracytoplasmic sperm injection (ICSI). Design: Retrospective study. Setting: Tertiary infertility center. Patient(s): Sibling oocytes of 104 patients in 104 IVF vs. ICSI cycles. Intervention(s): Cumulus oocyte complexes (n ϭ 1,358) were randomly subjected to ICSI or IVF. Main Outcome Measure(s): Embryo development and blastocyst formation rate. The blastocyst quality and cycle efficiency were also evaluated. Result(s): Early embryo cleavage was higher after ICSI (37.1%) compared to IVF (14.1%). The percentage of Ն4-cell embryos on day 2 and Ն8-cell embryos on day 3 was similar for both procedures. The overall blastocyst formation was not different between ICSI (50.2%) and IVF (54.8%), neither was the percentage of good-quality blastocysts (31.3% for ICSI and 36.0% for IVF). The total cycle efficiency (percentage of embryos transferred and frozen per two pronuclei [2PN]) was comparable for the two techniques (51.7% for ICSI and 57.4% for IVF). Conclusion(s): No differences were found on sibling oocytes in the embryo development and blastocyst formation, irrespective of the fertilization procedure. Earlier suggestions that the ICSI technique may result in impaired blastocyst development were not confirmed in this study.
Journal of SAFOG
Embryo transfers (ET) on day 2 or day 3 following fertilization have been the standard of practice since the initial days of human in vitro fertilization (IVF). Recent advances in culture media, as well as embryo culture techniques, have prompted in a shift in strategy to day 5 blastocyst transfers following IVF. However blastocyst transfers, although resulting in slightly better pregnancy rate, are known to be associated with certain disadvantages, such as higher costs, higher cycle cancellation rates, and in vitro damage to embryos. Thus we reviewed our results with day 2 and day 3 ETs to see whether outcomes were adequate to justify a return to day 3 embryo transfer policy. Our data shows a 46% clinical pregnancy rate and 1.9% incidence of multiple pregnancy rate with cleavage transfers. Thus in our setting with a lot of poor resource patients, we feel day 2 or 3 transfer provides a good strategy for IVF cycles.
Blastocyst transfer results in IVF ICSI cycles
Journal of South Asian Federation of Obstetrics and Gynaecology, 2018
Despite considerable advances in the field of in vitro fertilization (IVF), embryo implantation and pregnancy rates have plateaued globally. Thus, much of current research focus is on embryo and endometrial assessment. Day 3 embryo transfers (ETs) have been the standard of practice for long. However, development of blastocyst culture media has led to recent switch toward blastocyst transfers, although this is associated with greater technical skill and know-how in order to optimize the culture process. We analyzed our blastocyst transfer results to see whether this strategy appeared to be a viable intervention in terms of acceptable pregnancy outcome. Our study found a pregnancy rate of 37.5% with blastocyst transfers, with the complete absence of any multiple pregnancies. Thus, we feel blastocyst transfers represent a viable intervention in an IVF program to ensure acceptable pregnancy rates and simultaneously reduce the incidence of multiple births.
Health, 2012
Purpose: Evaluate the effect of preincubation of oocytes prior to IVF or ICSI cycles with embryo transfer at blastocyst stage. Methods: Retrospective non randomized study based on secondary analysis of data. Setting: Laboratory of Assisted Reproduction at the Alcivar Hospital. Patients: One hundred-eighteen cycles of IVF and ICSI were analyzed in the present study. The evaluated groups were formed for those patients whose oocytes, after retrieval, were inseminated at 1-3 h (Group I) or 4-6 h (Group II). Results: There was no difference in fertilization rate (83.6% and 78.1%), Day 3 cleavage rate (95.1% and 97.1%), and blastocyst formation (31.1% and 39.1%) for groups I and II respectively. Clinical pregnancy rates (PR: 53.0% vs 22.9%) and implantation rates (IR: 38.1% vs 13.0%) were significantly higher in group II versus group I, respectively (P < 0.05). Conclusions: Preincubation of oocytes before insemination is a factor which raises the PR and IR after the blastocyst transfer.
Human Reproduction, 1998
Excess embryos from patients undergoing intracytoplasmic sperm injection and embryo transfer for male infertility were cultured to determine the rate and timing of their progression to the blastocyst stage. In 194 embryo transfer cycles, four embryos with the morphologically best grading were transferred and at least two embryos were cultured. The cycles were classified as: group 1: no excess embryos reached blastocyst stage, group 2: Ͼ50% of embryos reached blastocyst stage by days 4-5, group 3: Ͻ50% of embryos reached the blastocyst stage by days 4-5, group 4: Ͼ50% of the embryos reached blastocyst stage by days 6-7, group 5: Ͻ50% of the embryos reached blastocyst stage by days 6-7. All groups were similar regarding female age, duration of infertility, and parameters of ovarian stimulation. In group 1, clinical pregnancy and implantation rates were 14 and 11% respectively, and were similar to those of group 4. In group 2, clinical pregnancy and implantation rates were 75 and 33%. Multiple implantations occurred in 81% of group 2 or 3 cycles, compared to none in group 1 cycles. The results suggest that the development potential of the embryo is intrinsic, and that embryos which carry a high potential for development yield a high clinical pregnancy rate and multiple implantations.
Journal of Assisted Reproduction and Genetics, 1996
ence on the results with intracvtoplasmic sperm injection. Methods: The quarterly outcome with both tCSI and traditional in vitro fertilization (IVF) in 1994 was analyzed in 475 patients under age 40 undergoing 595 oocyte retrievals. The data represent 307 patients undergoing 379 retrievals for IVF and 165 patients undergoing 216 retrievals for ICSI. Results: Fertilization rates with ICSI improved significantly each quarter (52.96, 62.17, 70.17, and 74.87% in Q-L Q-II, Q-HL and Q-IV respectively), while the rate with IVF improved signifcantly between Q-I (69.9%) and Q-If (80.10%) and slightly but significantly between Q-H and Q-IV (82.88%). The implantation rate per emb~. o after ICSI improved significantly after Q-I (6.17%) compared to Q-If (IO. 70%) and Q-IV (12.14%). The pregnancy rate per transfer with ICSI increased steadily after Q-I (13.79, 21.88, 23.53, and 25.00% in Q-I through Q-IV), reaching statistical significance between Q-I and Q-Ill and between Q-l and Q-IV Conclusions: Although acceptable results can be obtained with ICSI after a relatively short period of time, optimum results require substantial experience.
Fertility and Sterility, 1999
To evaluate the nonselective application of extended embryo culture on the outcome of IVF. Design: Retrospective analysis. Setting: Private practice assisted reproductive technology center. Patient(s): Seven hundred ninety nonselected patients undergoing IVF with controlled ovarian stimulation. Intervention(s): For day 3 ET, multicell embryos were cultured in human tubal fluid medium and 12% synthetic serum substitute. For day 5 ET, embryos were cultured for 48 hours in S1 medium and then for 48 hours in S2 medium. Main Outcome Measure(s): Implantation rate (determined by total no. of visualized gestational sacs), ongoing pregnancy rate, and number of embryos available for ET. Result(s): Respective day 3 and day 5 implantation rates for patients aged Ͻ35 years (29.5% and 38.9%), patients aged 35-39 years (20.7% and 28.2%), and all patients combined (23.3% and 32.4%) were statistically significantly different. Significantly more embryos were transferred on day 3 than on day 5 for patients aged Ͻ35 years (2.9 vs 2.4), patients aged 35-39 years (3.1 vs 2.6), and all patients combined (3.0 vs 2.5). The difference in ongoing pregnancy rates per retrieval was statistically significant for day 3 compared with day 5 transfers for all patients combined (35.9% vs 43.8%). Cancellation rates for transfer after retrieval increased significantly for day 3 compared with day 5 transfer (2.9% vs 6.7%).
Human Reproduction, 1996
This study was carried out to determine whether high insemination concentrations (HIC) could improve fertilization and pregnancy rates in patients who had either previously demonstrated poor fertilization rates in vitro using standard protocols (Group 1) or in whom a reduced chance of fertilization was indicated at semen assessment prior to in-vitro fertilization (TVF) (Groups 2 and 3). Forty nine patients were recruited for the study. Standard IVF was carried out in 1 ml volumes using 10 5 spermatozoa/ ml. HIC treatment involved co-culture of spermatozoa and oocytes in microdroplets with insemination concentrations increased 10-50 fold higher than standard IVF. Fertilization and pregnancy rates were compared between standard IVF and HIC in individual patients either in consecutive cycles (Group 1) or using sibling oocytes in the same cycle (Group 2). Group 3 patients were treated with HIC for their first treatment cycle. HIC significantly improved the fertilization rate compared with standard IVF for Groups 1 (59.7 ± 10.7 versus 19.6 ± 5.4% respectively) and 2 (54.9 ± 8.5 versus 34.0 ± 8.5% respectively). HIC increased the pregnancy rate from 0% with standard IVF to 20% per embryo transfer in Group 1 patients. A single pregnancy derived from the transfer of HIC and IVF embryos occurred in Group 2. The fertilization rate (47.2 ± 7.6%) and pregnancy rate (31.3% per embryo transfer) for Group 3 patients was higher than predicted. There was no increase in the rate of polyploidy with HIC. Provided there are sufficient numbers of motile spermatozoa, HIC may be offered as an initial form of treatment, thus permitting referral of only the poorest responders for intracytoplasmic sperm injection (ICSI).
Comparison of ICSI and conventional IVF in patients with increased oocyte immaturity
Reproductive BioMedicine Online, 2008
Using sibling oocytes, the objective of this study was to compare the intracytoplasmic sperm injection (ICSI) fertilization rates to those achieved with conventional IVF in patients with high rates of oocyte immaturity. This study was observational in nature, and included 91 patients who were treated using split insemination techniques. The fertilization rates for the ICSI group and the IVF group were 41.1 ± 15.0% and 53.2 ± 19.8%, respectively (P < 0.0001). There was no significant difference in day-3 embryo quality between the two groups. There was a significantly higher number of embryos frozen in the IVF group than in the ICSI group: 357 (84.8%) and 297 (76.7%), respectively (P = 0.037). Furthermore, the number of embryos either transferred or frozen was significantly higher in the IVF group than the ICSI group: 459 of 1173 (39.1%) and 385 of 1268 (30.4%), respectively (P < 0.0001). These data indicate that conventional IVF results in a higher fertilization rate than ICSI. Furthermore, IVF provided more embryos available for transfer or cryopreservation when compared with ICSI, thereby optimizing the patient's cycle.