Outcome of conventional IVF and ICSI on sibling oocytes in mild male factor infertility
| Autor: | Alain Michel Serkine, Albert Chouraqui, J.-M. Mayenga, Michelle Plachot, Laurent Tesquier, Joëlle Belaisch-Allart |
|---|---|
| Rok vydání: | 2002 |
| Předmět: |
Adult
Male medicine.medical_specialty medicine.medical_treatment Semen Fertilization in Vitro Intracytoplasmic sperm injection Andrology Embryonic and Fetal Development Human fertilization Pregnancy medicine Humans Embryo Implantation Infertility Male reproductive and urinary physiology Gynecology urogenital system business.industry Artificial insemination Rehabilitation Obstetrics and Gynecology Embryo Transfer Embryo Mammalian Oocyte medicine.disease Embryo transfer Treatment Outcome medicine.anatomical_structure Reproductive Medicine Fertilization embryonic structures Oocytes Female business therapeutics Embryo quality |
| Zdroj: | Human Reproduction. 17:362-369 |
| ISSN: | 1460-2350 |
| DOI: | 10.1093/humrep/17.2.362 |
| Popis: | BACKGROUND: Decisions concerning the treatment choice for assisted reproduction (IVF or ICSI) are usually made after the evaluation of male fertility factors, or after taking into account the results of previous IVF attempts. There are no widely accepted criteria, so decisions for couples with male subfertility are often empirical and may lead to complete fertilization failure after IVF, or to the unnecessary use of ICSI. METHODS: A study was conducted in which half the oocytes from each of 58 couples with moderate oligo astheno teratozoospermia were inseminated (conventional IVF) and the other half microinjected (ICSI). The technique used for subsequent cycles depended on the results of the first cycle. RESULTS: Nineteen of the 58 IVF/ICSI attempts resulted in fertilization after ICSI only (32.8%) and 39 in fertilization after IVF and ICSI (67.2%). For patients with oocyte fertilization only after ICSI, 61.5% of the oocytes microinjected were fertilized. A mean of 2.2 embryos per patient were transferred, leading to eight clinical pregnancies (42.1%).The implantation rate was 21.4%. All subsequent cycles were carried out with ICSI. Couples with oocyte fertilization after both IVF and ICSI had slightly better semen characteristics than those with oocyte fertilization only after ICSI, but this difference was not significant. Overall, no statistically significant difference was observed between IVF and ICSI in sibling oocytes for any of the variables studied: fertilization rate, embryo morphology and rates of development, pregnancy and implantation. Although only small numbers of oocytes or embryos were available for each couple, six couples had lower fertilization rates after IVF and eight had lower embryo quality after IVF. Eight patients had lower sperm quality in the second cycle, and only seven couples underwent subsequent IVF cycles. CONCLUSIONS: This strategy enabled us to avoid 32.8% of complete fertilization failures after IVF, but not to decrease significantly the number of ICSI attempts in subsequent cycles. However, the uncertainties concerning the safety of ICSI suggest that ICSI should be used cautiously and judiciously. |
| Databáze: | OpenAIRE |
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