Intracytoplasmic Sperm Injection Compared with in Vitro Fertilisation in Patients with Non-male Factor Infertility with Low Oocyte Retrieval: a Single-centre, Retrospective Cohort Study

Overview

Journal BMJ Open

Specialty General Medicine

Date 2024 Nov 14

PMID 39542474

Authors

Shaomi Zhu

Hengli Li

Zili Lv

Xin Liang

Liang Dong

Dongmei Tian

Affiliations

Soon will be listed here.

Abstract

Objective: To investigate the effects of in vitro fertilisation (IVF) and intracytoplasmic sperm injection (ICSI) on the clinical outcomes of non-male factor patients aged >35 with three or fewer oocytes retrieved.

Design: Retrospective cohort study.

Setting: Reproductive centre of a university-affiliated hospital in China.

Participants: 547 women with non-male factor infertility who underwent assisted reproductive technology (ART) treatment with three or fewer oocytes retrieved were identified from June 2019 to May 2022. Of these 547 patients, 334 were treated with IVF and 213 with ICSI.

Outcome Measures: The primary outcomes were normal fertilisation rate, live birth rate per transfer and cumulative live birth rate per retrieval.

Results: The baseline characteristics were comparable between the two groups, except for the proportion of primary infertility, which was higher in the ICSI group (17.66% vs 32.86%, p=0.000). Compared with the IVF group, the ICSI group showed higher normal fertilisation rate and lower cycle cancellation rate (65.99% vs 76.56%, p=0.002; 33.53% vs 24.41%, p=0.023). However, no significant differences were found in clinical pregnancy rate per transfer (23.86% vs 18.92%, p=0.545), miscarriage rate per fresh embryo transfer (19.05% vs 28.57%, p=0.595), live birth rate per transfer (17.05% vs 13.51%, p=0.623), cumulative clinical pregnancy rate per retrieval (12.87% vs 11.27%, p=0.576) and cumulative live birth rate per retrieval (9.28% vs 6.57%, p=0.261) between the two groups (p>0.05).

Conclusions: In non-male factor ART cycles, ICSI was not associated with improved pregnancy outcomes in older women with a low number of oocytes retrieved. Routine use of ICSI is not recommended in older women who are infertile due to non-male factors.

Citing Articles

Comparatively profiling the transcriptome of human, Porcine and mouse oocytes undergoing meiotic maturation.

Zhou N, Wang X, Xia Y, Liu Z, Luo L, Jin R BMC Genomics. 2025; 26(1):236.

PMID: 40075306 PMC: 11900275. DOI: 10.1186/s12864-025-11431-1.

Non-Male Factor Only-ICSI Can Overcome Oocyte Factor in PCOS Patients.

Shibli Abu Raya Y, Aslih N, Atzmon Y, Sharqawi M, Shavit M, Bilgory A J Clin Med. 2025; 14(1.

PMID: 39797326 PMC: 11721918. DOI: 10.3390/jcm14010244.

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