Fertilization after standard in vitro fertilization versus intracytoplasmic sperm injection in subfertile males using sibling oocytes

Pisarska, Margareta D; Casson, Peter R; Cisneros, Pauline L; Lamb, Dolores J; Lipshultz, Larry I; Buster, John E; Carson, Sandra A

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Volume 71, Issue 4 , Pages 627-632, April 1999

Fertilization after standard in vitro fertilization versus intracytoplasmic sperm injection in subfertile males using sibling oocytes

Presented at the 53rd Annual Meeting of the American Society of Reproductive Medicine, Cincinnati, Ohio, October 18–22, 1997.

Margareta D Pisarska, M.D.
- Baylor Assisted Reproductive Technology Program, Baylor College of Medicine, Houston, Texas, USA
- Department of Obstetrics and Gynecology.
Peter R Casson, M.D.
- Baylor Assisted Reproductive Technology Program, Baylor College of Medicine, Houston, Texas, USA
- Department of Obstetrics and Gynecology.
Pauline L Cisneros, Ph.D.
- Baylor Assisted Reproductive Technology Program, Baylor College of Medicine, Houston, Texas, USA
- Department of Obstetrics and Gynecology.
Dolores J Lamb, Ph.D.
- Baylor Assisted Reproductive Technology Program, Baylor College of Medicine, Houston, Texas, USA
- Scott Department of Urology.
- Department of Cell Biology.
Larry I Lipshultz, M.D.
- Baylor Assisted Reproductive Technology Program, Baylor College of Medicine, Houston, Texas, USA
- Scott Department of Urology.
John E Buster, M.D.
- Baylor Assisted Reproductive Technology Program, Baylor College of Medicine, Houston, Texas, USA
- Department of Obstetrics and Gynecology.
Sandra A Carson, M.D.
- Baylor Assisted Reproductive Technology Program, Baylor College of Medicine, Houston, Texas, USA
- Department of Obstetrics and Gynecology.
- Reprint requests: Sandra A. Carson, M.D., Department of Obstetrics and Gynecology, Baylor College of Medicine, 6550 Fannin, Suite 801 Houston, Texas 77030 (FAX: 713-798-8431)

Received 16 July 1998; received in revised form 23 November 1998; accepted 23 November 1998.

Abstract

Objective: To compare conventional IVF with ICSI in the subfertile male population using sibling oocytes. Results from males with isolated severe teratozoospermia also are analyzed.

Design: Prospective experimental study.

Setting: University based IVF clinic.

Patient(s): Group A: 18 patients with one or more abnormalities in count, motility, or morphology. Group B: 20 patients with isolated severe teratozoospermia (≤4% Kruger Strict Criteria).

Intervention(s): Ovulation induction, random allocation of sibling oocytes, and IVF or ICSI.

Main Outcome Measure(s): Fertilization rates (fertilization per cycle, fertilization per oocytes, and fertilization per couple) and embryo quality.

Result(s): In group A, fertilization occurred in 13 of 18 (72%) of IVF cycles and 17 of 18 (94%) of ICSI cycles. Overall, 69 of 120 (58%) oocytes fertilized after IVF, whereas 80 of 131 (61%) fertilized after ICSI. The mean (±SEM) percent of oocytes fertilized per couple was 44.6% ± 9.0% with IVF and 62.7% ± 5.6% with ICSI (not statistically significant). In group B, fertilization occurred in 18 of 20 (90%) cycles after IVF and 20 of 20 (100%) cycles with ICSI. Overall, 54 of 113 (48%) of the oocytes fertilized after IVF, whereas 82 of 124 (66%) fertilized with ICSI. The mean (±SEM) percent of oocytes fertilized per couple was 50.9% ± 7.1% with IVF and 66.6% ± 4.7% with ICSI. No statistically significant difference in embryo quality after IVF versus ICSI was demonstrated.

Conclusion(s): With severe teratozoospermia, ICSI results in higher fertilization rates than conventional IVF, without altering embryo quality. In our subfertile male population, there is a trend toward improved fertilization with ICSI, with less failed fertilization.

Keywords: Subfertile males, teratozoospermia, sibling oocytes, in vitro fertilization, intracytoplasmic sperm injection, fertilization, embryo quality