Clin Exp Reprod Med.  2017 Jun;44(2):96-104. 10.5653/cerm.2017.44.2.96.

Comparison of clinical outcomes between in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI) in IVF-ICSI split insemination cycles

• Lee SH
• Lee JH
• Park YS
• Yang KM
• Lim CK

• KMID: 2405157
• DOI: http://doi.org/10.5653/cerm.2017.44.2.96

Abstract

OBJECTIVE
This study aimed to compare the clinical outcomes between in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI) in sibling oocytes. Additionally, we evaluated whether the implementation of split insemination contributed to an increase in the number of ICSI procedures.
METHODS
A total of 571 cycles in 555 couples undergoing split insemination cycles were included in this study. Among them, 512 cycles (89.7%) were a couple's first IVF cycle. The patients were under 40 years of age and at least 10 oocytes were retrieved in all cycles. Sibling oocytes were randomly allocated to IVF or ICSI.
RESULTS
Total fertilization failure was significantly more common in IVF cycles than in ICSI cycles (4.0% vs. 1.4%, p<0.05), but the low fertilization rate among retrieved oocytes (as defined by fertilization rates greater than 0% but <30%) was significantly higher in ICSI cycles than in IVF cycles (17.2% vs. 11.4%, p<0.05). The fertilization rate of ICSI among injected oocytes was significantly higher than for IVF (72.3%±24.3% vs. 59.2%±25.9%, p<0.001), but the fertilization rate among retrieved oocytes was significantly higher in IVF than in ICSI (59.2%±25.9% vs. 52.1%±22.5%, p<0.001). Embryo quality before embryo transfer was not different between IVF and ICSI. Although the sperm parameters were not different between the first cycle and the second cycle, split insemination or ICSI was performed in 18 of the 95 cycles in which a second IVF cycle was performed.
CONCLUSION
The clinical outcomes did not differ between IVF and ICSI in split insemination cycles. Split insemination can decrease the risk of total fertilization failure. However, unnecessary ICSI is carried out in most split insemination cycles and the use of split insemination might make ICSI more common.

Keyword

Fertilization failure; In vitro fertilization; Intracytoplasmic sperm injection; Low fertilization; Split insemination

MeSH Terms

Embryo Transfer
Embryonic Structures
Family Characteristics
Fertilization
Fertilization in Vitro*
Humans
In Vitro Techniques*
Insemination*
Oocytes
Siblings
Sperm Injections, Intracytoplasmic*
Spermatozoa