ICSI may be no better than conventional IVF in instances of non-male infertility
Intracytoplasmic sperm injection (ICSI) is the worldwide favored method of fertilization for assisted reproduction. New data suggest there is no justification for the use of ICSI in cases of non-male infertility.
Intracytoplasmic sperm injection (ICSI) is often employed in assisted reproduction. A new study, however, has found that in instances of non-male infertility, ICSI offers no benefits over conventional IVF therapy.
ICSI was developed to improve conception rates in cases of male-related infertility. Since its development, however, ICSI has been routinely employed as a fertilization technique in instances of non-male infertility too.
ICSI therapy currently outnumbers conventional IVF therapy for use in assisted reproduction worldwide.
A new population-based study, assessing almost 5000 patients in Belgium and Spain receiving either ICSI or IVF therapy for assisted reproduction, has found no benefit – as assessed by fresh and cumulative live birth rates – of ICSI over traditional IVF, in cases of non-male related infertility.
Panagiotis Drakapoulos, of UZ Brussels (Jette, Belgium), where ICSI was developed, noted: “There has been a worldwide increase in the use of ICSI for all causes of infertility…The rationale for this seems to be that ICSI is associated with a higher likelihood of fertilization and an increased number of embryos – but this is controversial.”
Drakapoulos continued: “…ICSI is the first choice for fertilization in many centers in patients who respond mildly to ovarian stimulation and have few eggs retrieved. But there is currently no evidence on the comparative effectiveness of ICSI and IVF according to the number of oocytes retrieved in patients with non-male factor infertility. This study for the first time aimed to provide that evidence using a large sample size.”
The study found no difference in fertilization or live birth rates in patients who received ICSI versus conventional IVF.
Further, these success rates were similar amongst patients categorized as ‘poor ovarian responders’ – from whom 1—3 eggs were successfully retrieved – or those classified as ‘high ovarian responders’ – from whom more than 15 eggs were successfully retrieved.
Drakapoulos commented that these results demonstrate “…that the number of oocytes retrieved has no value in the selection of the insemination procedure in cases of non-male infertility”.
Drakapoulos concluded: “The rationale for the high use of ICSI in non-male factor cases…is based on a wrong assumption that ICSI may be associated with a higher likelihood of fertilization and an increased number of available embryos...our results show that this assumption is misplaced.”