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J Assist Reprod Genet. 2019 Oct;36(10):2067-2076. doi: 10.1007/s10815-019-01563-1. Epub 2019 Aug 22.

ICSI does not offer any benefit over conventional IVF across different ovarian response categories in non-male factor infertility: a European multicenter analysis.

Author information

1
Center for Reproductive Medicine, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Laarbeeklaan 101, 1090, Brussels, Belgium. panagiotisdrakopoulos@hotmail.com.
2
Faculty of Medicine and Pharmacy, Department of Surgical and Clinical Science, Vrije Universiteit Brussel, Brussels, Belgium. panagiotisdrakopoulos@hotmail.com.
3
Instituto Valenciano de Infertilidad, IVI-RMA Madrid, Madrid, Spain.
4
Rey Juan Carlos University, Madrid, Spain.
5
Instituto Valenciano de Infertilidad, IVI-RMA Valencia, Valencia, Spain.
6
Center for Reproductive Medicine, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Laarbeeklaan 101, 1090, Brussels, Belgium.
7
Faculty of Medicine and Pharmacy, Department of Surgical and Clinical Science, Vrije Universiteit Brussel, Brussels, Belgium.
8
IVI-RMA Lisbon, Lisbon, Portugal.
9
Department of Obstetrics and Gynecology, Faculty of Medicine, University of Lisbon, Lisbon, Portugal.
10
Department of Obstetrics and Gynecology, Medical School, University of Crete, 71110, Heraklion, Crete, Greece.
11
Department of Reproductive Medicine, Dexeus University Hospital, Barcelona, Spain.

Abstract

PURPOSE:

To evaluate whether ICSI offers any benefit compared with IVF in different ovarian response categories in case of non-male factor infertility.

METHODS:

This is a retrospective multicenter analysis using individual patient data, conducted in 15 tertiary referral hospitals in Europe (1 center in Belgium and 14 in Spain). The study included the first cycle of all patients undergoing ovarian stimulation for IVF or ICSI in a GnRH antagonist protocol. Only patients having either IVF or ICSI for non-male factor infertility were included. Patients were divided into 4 groups based on their ovarian response as follows: group A, poor responders (1-3 oocytes); group B, suboptimal responders (4-9 oocytes); group C, normal responders (10-15 oocytes); group D, high responders (> 15 oocytes).

RESULTS:

In total, 4891 patients were analyzed, of whom 4227 underwent ICSI and 664 IVF. There was no significant difference for the insemination method (ICSI vs. IVF) used among the different ovarian response categories: 87% vs. 13%, 87% vs. 13%, 86% vs. 14%, 84% vs. 16%, for groups A, B, C, and D, respectively, p value = 0.35. Mean fertilization rates and embryo utilization rates were comparable between IVF and ICSI in the whole cohort. Fresh and cumulative LBR did not differ significantly for IVF and ICSI in poor, suboptimal, normal, and high responders.

CONCLUSION:

There is no advantage of ICSI over IVF as insemination method for non-male factor infertility, irrespective of the ovarian response. The number of oocytes retrieved has no value for the selection of the insemination procedure in case of non-male infertility.

KEYWORDS:

Fertilization rates; ICSI; IVF; Oocytes; Ovarian response

PMID:
31440957
PMCID:
PMC6823343
[Available on 2020-10-01]
DOI:
10.1007/s10815-019-01563-1

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