2013년 미국불임학회(ASRM) P- 303 Is ICSI essential for cases with less than three MII oocytes? (성숙 난자가 3개 이하인 경우 미세수정을 시행하는 것이 반드시 필요한가?)

Youn Young Kim1, IlHae Park1, Kyeong Ho Lee1, Hong Gil Sun1, SeokGi Kim1 and Hye Jin Kim1.
1 Infertility clinic, Mamapapa&baby obstetrics and Gynecology, HWASHIN BLD 4F 1367-5-DAL-DONG, NAM-KU ULSAN, x, Republic of Korea, 680805

INTRODUCTION

ICSI is a technique of fertilization developed to treat male infertility. However, it has become routine to use ICSI in case of unexplained infertility, poor fertilization, and low egg number, despite the lack of clinical evidence to support its use. The purpose of our study was to evaluate effectiveness of ICSI vs. conventional IVF in non-male infertility couples with three or less matures.

DESIGN

A retrospective study

MATERIALS AND METHODS

All fresh, non-donor IVF cycles were performed from January 2007 through December 2012 (n=3034). This study included 146cycles with a non-male factor and less than three MII oocytes. Consequently, cycles were divided into the conventional IVF group (n=84) and ICSI group (n=62) according to the method of fertilization. In conventional IVF, each oocyte was inseminated within 4-5 hours after retrieval by adding 10,000 motile spermatozoa. We use ICSI for the patient who experienced unfertile IVF cycle or had no history of pregnancy. Outcome measures included method of fertilization, embryo quality, pregnancy rate and ongoing pregnancy rate.

RESULTS

The differences in mean age (IVF: 34.6±2.9; ICSI: 34.3±2.9 P=0.65), basal FSH (7±1.4; 6.9±1.4 P=0.75), duration of rFSH (9.4±2.4; 9.6±2.7 P=0.62), endometrial thickness (9.7±2.0; 10.5±2.6 P=0.06) were not statistically significant. The only statistically significant differences between the IVF and ICSI groups were: history of pregnancy (61.9%; 53.2% P=0.04) and prior IVF cycle (48.4%; 38.1% P=0.03). The differences in the number of MII oocytes (2.6±0.5; 2.5±0.5 P=0.70), fertilization rate (92.3±17.4; 90.3±20.4 p=0.54), the mean number of transferred embryo (2.0±0.4; 2.0±0.6 P=0.24), pregnancy rate (51.2; 37.1 P=0.09) and on-going pregnancy rate (47.6; 35.5 P=0.74) between IVF and ICSI were not statistically significant.

CONCLUSION

We found that ICSI in non-male factor infertility with three or less MII oocytes was not associated with improved fertilization rate and pregnancy rate.