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Intracytoplasmic sperm injection as a treatment for unexplained total fertilization failure or low fertilization after conventional in vitro fertilization.
Fertil Steril. 2005 Mar; 83(3):612-7.FS

Abstract

OBJECTIVE

To determine whether IVF or intracytoplasmic sperm injection (ICSI) should be the choice of treatment in case of a previous IVF attempt with unexplained total fertilization failure or low fertilization (<25%).

DESIGN

Prospective study.

SETTING

Leiden University Medical Center.

PATIENT(S)

Thirty-eight couples undergoing IVF and ICSI on sibling oocytes after a first IVF attempt with total fertilization failure or with low fertilization (<25%).

INTERVENTION(S)

Performing IVF and ICSI on sibling oocytes.

MAIN OUTCOME MEASURE(S)

Fertilization and (ongoing) pregnancy rate.

RESULT(S)

A total of 271 oocytes were collected in 24 oocyte retrievals in the total fertilization failure group. Hundred nine oocytes were randomly allocated to IVF and 12 were fertilized (11%); 162 sibling oocytes were allocated to ICSI and 78 were fertilized (48%). In 8 of the 24 patients fertilization occurred after IVF. The pregnancy rate after transfer of 1 IVF and 1 ICSI embryo (n = 3) was 67% and after the transfer of 2 ICSI embryos (n = 21) this was 52%. In the low fertilization group 169 oocytes were collected in 14 oocyte retrievals. Seventy-two oocytes were randomly allocated to IVF and 16 were fertilized (22%). Ninety-seven sibling oocytes were allocated to ICSI and 58 were fertilized (60%). In 7 of 14 patients fertilization occurred after IVF. The pregnancy rate after the transfer of 1 IVF and 1 ICSI embryo (n = 5) was 80% and after the transfer of 2 ICSI embryos (n = 9) this was 33%.

CONCLUSION(S)

Performing ICSI on some oocytes of a cohort may avoid total fertilization failures both in patients with a history of total fertilization failure and in patients with a history of low fertilization, as the percentage of fertilization is higher after ICSI compared to IVF and the recurrence of total fertilization failure and low fertilization is high after IVF treatment.

Authors+Show Affiliations

Department of Reproductive Medicine, Leiden University Medical Center, Leiden, The Netherlands. L.A.van_der_Westerlaken@LUMC.nlNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Comparative Study
Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

15749489

Citation

van der Westerlaken, Lucette, et al. "Intracytoplasmic Sperm Injection as a Treatment for Unexplained Total Fertilization Failure or Low Fertilization After Conventional in Vitro Fertilization." Fertility and Sterility, vol. 83, no. 3, 2005, pp. 612-7.
van der Westerlaken L, Helmerhorst F, Dieben S, et al. Intracytoplasmic sperm injection as a treatment for unexplained total fertilization failure or low fertilization after conventional in vitro fertilization. Fertil Steril. 2005;83(3):612-7.
van der Westerlaken, L., Helmerhorst, F., Dieben, S., & Naaktgeboren, N. (2005). Intracytoplasmic sperm injection as a treatment for unexplained total fertilization failure or low fertilization after conventional in vitro fertilization. Fertility and Sterility, 83(3), 612-7.
van der Westerlaken L, et al. Intracytoplasmic Sperm Injection as a Treatment for Unexplained Total Fertilization Failure or Low Fertilization After Conventional in Vitro Fertilization. Fertil Steril. 2005;83(3):612-7. PubMed PMID: 15749489.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Intracytoplasmic sperm injection as a treatment for unexplained total fertilization failure or low fertilization after conventional in vitro fertilization. AU - van der Westerlaken,Lucette, AU - Helmerhorst,Frans, AU - Dieben,Sandra, AU - Naaktgeboren,Nico, PY - 2004/04/20/received PY - 2004/08/16/revised PY - 2004/08/16/accepted PY - 2005/3/8/pubmed PY - 2005/5/6/medline PY - 2005/3/8/entrez SP - 612 EP - 7 JF - Fertility and sterility JO - Fertil. Steril. VL - 83 IS - 3 N2 - OBJECTIVE: To determine whether IVF or intracytoplasmic sperm injection (ICSI) should be the choice of treatment in case of a previous IVF attempt with unexplained total fertilization failure or low fertilization (<25%). DESIGN: Prospective study. SETTING: Leiden University Medical Center. PATIENT(S): Thirty-eight couples undergoing IVF and ICSI on sibling oocytes after a first IVF attempt with total fertilization failure or with low fertilization (<25%). INTERVENTION(S): Performing IVF and ICSI on sibling oocytes. MAIN OUTCOME MEASURE(S): Fertilization and (ongoing) pregnancy rate. RESULT(S): A total of 271 oocytes were collected in 24 oocyte retrievals in the total fertilization failure group. Hundred nine oocytes were randomly allocated to IVF and 12 were fertilized (11%); 162 sibling oocytes were allocated to ICSI and 78 were fertilized (48%). In 8 of the 24 patients fertilization occurred after IVF. The pregnancy rate after transfer of 1 IVF and 1 ICSI embryo (n = 3) was 67% and after the transfer of 2 ICSI embryos (n = 21) this was 52%. In the low fertilization group 169 oocytes were collected in 14 oocyte retrievals. Seventy-two oocytes were randomly allocated to IVF and 16 were fertilized (22%). Ninety-seven sibling oocytes were allocated to ICSI and 58 were fertilized (60%). In 7 of 14 patients fertilization occurred after IVF. The pregnancy rate after the transfer of 1 IVF and 1 ICSI embryo (n = 5) was 80% and after the transfer of 2 ICSI embryos (n = 9) this was 33%. CONCLUSION(S): Performing ICSI on some oocytes of a cohort may avoid total fertilization failures both in patients with a history of total fertilization failure and in patients with a history of low fertilization, as the percentage of fertilization is higher after ICSI compared to IVF and the recurrence of total fertilization failure and low fertilization is high after IVF treatment. SN - 0015-0282 UR - https://www.unboundmedicine.com/medline/citation/15749489/Intracytoplasmic_sperm_injection_as_a_treatment_for_unexplained_total_fertilization_failure_or_low_fertilization_after_conventional_in_vitro_fertilization_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0015-0282(04)03031-6 DB - PRIME DP - Unbound Medicine ER -