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A randomized controlled trial of laser-assisted ICSI
Mohamed Fawzy1,2, Mai Emad1,2, Ali Mahran2,3
1IbnSina IVF Centre, IbnSina Hospital, Sohag, Egypt.
Human Reproduction (Oxford, England)
|September 30, 2020
Summary
Laser-assisted ICSI (LA-ICSI) improves oocyte survival but does not enhance embryo development or pregnancy rates compared to conventional ICSI. Further evidence is needed to justify its widespread clinical use.
Area of Science:
- Reproductive Medicine
- Assisted Reproductive Technology (ART)
Background:
- Oocyte degeneration is a concern in intracytoplasmic sperm injection (ICSI).
- Laser-assisted ICSI (LA-ICSI) is a technique that may improve oocyte survivability.
Purpose of the Study:
- To evaluate if LA-ICSI improves oocyte survival, embryo development, and clinical outcomes compared to conventional ICSI.
Main Methods:
- A randomized controlled trial involving 966 couples and 16,122 oocytes.
- Comparison of LA-ICSI versus conventional ICSI, with oocyte survival as the primary endpoint.
- Analysis of embryo development and ongoing pregnancy rates.
Main Results:
- LA-ICSI showed higher oocyte survival rates (RR 1.08) and increased fertilized oocytes and utilizable blastocysts initially.
- However, after adjusting for oocyte survival, no significant benefit in embryo development or utilization was observed.
- Ongoing pregnancy rates were similar between LA-ICSI and conventional ICSI (OR 0.79).
Conclusions:
- While LA-ICSI improves oocyte survival, it does not demonstrate a significant benefit for embryo development or clinical outcomes like pregnancy rates.
- The clinical utility of LA-ICSI requires further demonstration of improved pregnancy rates to justify its use over conventional ICSI.
