Conventional IVF revisited: Is ICSI better for non-male factor infertility? Randomized controlled double blind study

Area of Science:

• Reproductive Medicine
• Assisted Reproductive Technology
• Infertility Treatment

Background:

• Intracytoplasmic sperm injection (ICSI) use has increased in non-male factor infertility despite conventional in vitro fertilization (IVF) often favoring a better risk/benefit analysis.
• Total fertilization failure is a significant concern for patients and professionals undergoing assisted reproductive technologies.

Purpose of the Study:

• To compare the efficacy of conventional IVF versus ICSI in couples with non-male factor infertility.
• To evaluate fertilization, clinical pregnancy, implantation, and miscarriage rates between the two methods.

Main Methods:

• A randomized controlled double-blind study involving 138 women undergoing assisted reproductive technology (ART).
• Sibling oocytes were randomly allocated to either conventional IVF or ICSI for fertilization.
• Outcomes were compared between the IVF and ICSI groups, with embryo transfer decisions based on embryo quality.

Main Results:

• Fertilization rate per inseminated oocyte was significantly higher in the ICSI group (63.78%) compared to the IVF group (56.20%).
• Ten cases of total fertilization failure occurred exclusively in the IVF group.
• Clinical pregnancy rates (63% vs. 49%), implantation rates (31% vs. 28%), and abortion rates (12.5% vs. 8.1%) were similar between the conventional IVF and ICSI groups, respectively.

Conclusions:

• Conventional IVF is a suitable and cost-effective choice for non-male factor infertility, offering similar clinical outcomes to ICSI.
• Limitations include the absence of live birth rates and the need for careful interpretation of results due to sibling oocyte randomization.