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No Advantage Of Sperm Injection Over Conventional IVF For Non-Male-Factor Infertility.(in-vitro fertilization)
2001 JUL 26 - (NewsRx Network) -- Two studies in the June 30, 2001, issue of the Lancet examine the use of intracytoplasmic sperm injection (ICSI) fertility treatment.
ICSI is a more invasive option than conventional in-vitro fertilization (IVF), which can be successful even when semen characteristics are poor. Previous reports of higher fertilization rates after ICSI suggest that this technique may be better than the conventional method for all couples seeking IVF.
Siladitya Bhattacharya and colleagues from Aberdeen University, Scotland, U.K., did a multicenter, randomized, controlled trial comparing outcome after ICSI or traditional IVF in couples with non-male-factor infertility. They randomly assigned 415 couples at four U.K. centers to IVF or ICSI. The primary outcome was the implantation rate (number of gestation sacs per embryo replaced expressed as a percentage); secondary outcomes were pregnancy and fertilization rates associated with each treatment (Lancet, June 30, 2001;357(9274):2068, 2075).
The implantation rate was higher in the conventional IVF group (30%) than in the ICSI group (22%), Bhattacharya and team reported. The pregnancy rate per cycle was also higher after conventional IVF (33% compared with 26%). The average laboratory time was substantially shorter with conventional IVF than with ICSI (23 minutes compared with 74 minutes).
The investigators concluded that their results support the current practice of reserving ICSI only for severe male fertility problems.
In an accompanying commentary, Sergio Oehninger from Eastern Virginia Medical School, U.S., cautioned that the study did not address the impact of the future use of cryopreserved embryos derived from the ICSI and IVF cycles. He commented that this issue needs to be clarified, since the "total reproductive potential" probably represents the best estimate of the overall efficacy of assisted reproductive technique procedures.
Nevertheless, Oehninger endorsed the current practice of indicating ICSI only for male-factor infertility.
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