International Journal of Reproductive BioMedicine

Published date: Feb 20 2025

Journal Title: International Journal of Reproductive BioMedicine

Issue title: International Journal of Reproductive BioMedicine (IJRM): Volume 23, Issue No. 1

Pages: 45 - 54

DOI: 10.18502/ijrm.v23i1.18190

Sajad Zare GariziStudent Research Committee, Shahid Sadoughi University of Medical Sciences, Yazd

Nazanin Sabagh Nezhad YazdStudent Research Committee, Shahid Sadoughi University of Medical Sciences, Yazd

Nasim Tabibnejadnasimtabibnejad@ssu.ac.irResearch and Clinical Center for Infertility, Yazd Reproductive Sciences Institute, Shahid Sadoughi University of Medical Sciences, Yazd

Razieh Dehghani-Firouzabadidr_firouzabadi@ssu.ac.irResearch and Clinical Center for Infertility, Yazd Reproductive Sciences Institute, Shahid Sadoughi University of Medical Sciences, Yazd

Background: Intracytoplasmic sperm injection (ICSI) was originally developed to facilitate fertilization in situations of severe male infertility. However, it is now frequently used for nonmale factor infertility, such as advanced maternal age or low oocyte count, despite the clinical advantages of this method has not been proven for these situations.

Objective: This study aims to compare pregnancy and neonatal outcomes between ICSI and in vitro fertilization (IVF) cycles in women with advanced maternal age and nonmale factor infertility.

Materials and Methods: This retrospective cross-sectional study included 1090 women with nonmale factor infertility, who underwent fresh embryo transfer cycles of IVF or ICSI at the Yazd Reproductive Sciences Institute, Yazd, Iran between April 2018 and June 2023. Data on demographic characteristics, clinical outcomes, and neonatal outcomes were analyzed from electronic medical records.

Results: Women undergoing IVF demonstrated significantly higher outcomes in fertilization, implantation, and chemical pregnancy rate (p < 0.05). Neonatal outcomes showed significantly higher twin birth weights and lower prematurity rates in the IVF group compared to the ICSI group (p < 0.001 and p = 0.011, respectively).

Conclusion: This study suggests that IVF may yield better maternal outcomes and more favorable neonatal results than ICSI for older women with nonmale factor infertility. These results emphasize the significance of tailored treatment plans and the necessity for continued research to enhance assisted reproductive technologies techniques.

Keywords: Infertility, Intracytoplasmic sperm injection, In vitro fertilization, Advanced maternal age, Pregnancy outcome

[1] Enmozhi SK, Joseph J. SARS-CoV-2 and its repercussive effect on reproductive health: Recent trends. Future Virology 2022; 17: 607–610.

[2] Inhorn MC, Patrizio P. Infertility around the globe: New thinking on gender, reproductive technologies and global movements in the 21st century. Hum Reprod Update 2015; 21: 411–426.

[3] Farhi J, Cohen K, Mizrachi Y, Weissman A, Raziel A, Orvieto R. Should ICSI be implemented during IVF to all advanced-age patients with non-male factor subfertility? Reprod Biol Endocrinol 2019; 17: 30.

[4] Liu L, Wang H, Li Z, Niu J, Tang R. Obstetric and perinatal outcomes of intracytoplasmic sperm injection versus conventional in vitro fertilization in couples with nonsevere male infertility. Fertil Steril 2020; 114: 792–800.

[5] McPherson NO, Vincent AD, Pacella-Ince L, Tremellen K. Comparison of in vitro fertilisation/intracytoplasmic sperm injection on live birth rates in couples with non-male factor infertility and advanced maternal age. J Assist Reprod Genet 2021; 38: 669–678.

[6] Dashti S, Pejman A, Tabibnejad N, Mortezanasab M. The effect of transferring a poor-quality embryo together with a good-quality embryo on the singleton birth weight: A retrospective cohort study. Int J Repro BioMed 2022; 20: 79–90.

[7] Tannus S, Son W-Y, Gilman A, Younes G, Shavit T, Dahan M-H. The role of intracytoplasmic sperm injection in non-male factor infertility in advanced maternal age. Hum Reprod 2017; 32: 119–124.

[8] Abbas AM, Hussein RS, Elsenity MA, Samaha II, El Etriby KA, Abd El-Ghany MF, et al. Higher clinical pregnancy rate with in-vitro fertilization versus intracytoplasmic sperm injection in treatment of non-male factor infertility: Systematic review and meta-analysis. J Gynecol Obstet Hum Reprod 2020; 49: 101706.

[9] Li Z, Wang A, Bowman M, Hammarberg K, Farquhar C, Johnson L, et al. ICSI does not increase the cumulative live birth rate in non-male factor infertility. Hum Reprod 2018; 33: 1322–1330.

[10] Davies MJ, Moore VM, Willson KJ, Van Essen P, Priest K, Scott H, et al. Reproductive technologies and the risk of birth defects. N Engl J Med 2012; 366: 1803–1813.

[11] Nouri K, Ott J, Stoegbauer L, Pietrowski D, Frantal S, Walch K. Obstetric and perinatal outcomes in IVF versus ICSI-conceived pregnancies at a tertiary care center-a pilot study. Reprod Biol Endocrinol 2013; 11: 84.

[12] World Health Organization. WHO laboratory manual for the examination and processing of human semen. Switzerland: World Health Organization Press; 2021.

[13] Jiesisibieke D, Tian T, Zhu X, Fang S, Zhang N, Ma J, et al. Reproductive outcomes of conventional in vitro fertilization and intracytoplasmic sperm injection in patients with non-severe male infertility across poor and different sub-optimal ovarian response categories: A cohort study based on 30,352 fresh cycles from 2009–2019. Reprod Sci 2024; 31: 1353–1362.

[14] Fancsovits P, Lehner A, Kaszas Z, Nemes A, Dudas B, Murber A, et al. Intracytoplasmic sperm injection does not improve the outcome of IVF treatments in patients with advanced maternal age or low oocyte number: A randomized controlled trial. J Gynecol Obstet Hum Reprod 2023; 52: 102625.

[15] ESHRE Special Interest Group of Embryology and Alpha Scientists in Reproductive Medicine. The vienna consensus: Report of an expert meeting on the development of ART laboratory performance indicators. Reprod BioMed Online 2017; 35: 494–510.

[16] Haas J, Miller TE, Nahum R, Aizer A, Kirshenbaum M, Zilberberg E, et al. The role of ICSI vs. conventional IVF for patients with advanced maternal age: A randomized controlled trial. J Assist Reprod Genet 2021; 38: 95–100.

[17] Drakopoulos P, Garcia-Velasco J, Bosch E, Blockeel C, de Vos M, Santos-Ribeiro S, et al. ICSI does not offer any benefit over conventional IVF across different ovarian response categories in non-male factor infertility: A European multicenter analysis. J Assist Reprod Genet 2019; 36: 2067–2076.

[18] Dang VQ, Vuong LN, Luu TM, Pham TD, Ho TM, Ha AN, et al. Intracytoplasmic sperm injection versus conventional in-vitro fertilisation in couples with infertility in whom the male partner has normal total sperm count and motility: An open-label, randomised controlled trial. Lancet 2021; 397: 1554–1563.

[19] Kim JY, Kim JH, Jee BC, Lee JR, Suh CS, Kim SH. Can intracytoplasmic sperm injection prevent total fertilization failure and enhance embryo quality in patients with non-male factor infertility? Eur J Obstet Gynecol Reprod Biol 2014; 178: 188–191.

[20] Pandey S, Shetty A, Hamilton M, Bhattacharya S, Maheshwari A. Obstetric and perinatal outcomes in singleton pregnancies resulting from IVF/ICSI: A systematic review and meta-analysis. Hum Reprod Update 2012; 18: 485–503.

[21] Yan J, Huang G, Sun Y, Zhao X, Chen S, Zou S, et al. Birth defects after assisted reproductive technologies in China: Analysis of 15,405 offspring in seven centers (2004 to 2008). Fertil Steril 2011; 95: 458–460.

[22] Bonduelle M, Liebaers I, Deketelaere V, Derde M-P, Camus M, Devroey P, et al. Neonatal data on a cohort of 2889 infants born after ICSI (1991–1999) and of 2995 infants born after IVF (1983–1999). Hum Reprod 2002; 17: 671–694.