Conventional in vitro fertilisation rather than intracytoplasmic sperm injection when only one oocyte is retrieved: Time to overcome irrational fears

IF 1.4 4区 医学 Q3 OBSTETRICS & GYNECOLOGY
Valerio Pisaturo, Marco Reschini, Cristina Guarneri, Elena Sanzani, Alessio Paffoni, Edgardo Somigliana
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引用次数: 0

Abstract

Background

The use of intracytoplasmic sperm injection (ICSI) currently extends beyond male factor infertility, notably replacing conventional in vitro fertilisation (IVF) in scenarios like limited oocyte availability, where it is used as a precaution against complete fertilisation failure. While existing studies on the use of conventional IVF in such situations provide some reassurance, the available evidence is somewhat insufficient and ICSI is commonly used.

Aims

To evaluate whether conventional IVF can be a feasible option when only one oocyte is retrieved.

Materials and Methods

A retrospective study was performed to evaluate the fertilisation rate with conventional IVF in women retrieving only one oocyte and whose partner had normal semen. The study aimed at evaluating whether the fertilisation rate was aligned with the threshold indicated by recognized IVF laboratory performance indicators (Vienna Consensus). Clinical pregnancy and live birth rates were secondary outcomes.

Results

Out of 304 cycles with a single oocyte inseminated with conventional IVF, 209 achieved normal fertilisation and 82 did not. Thirteen had no mature oocytes. The fertilisation rate was 69% (95% CI: 63–74%) and increased to 72% (95% CI: 66–77%) when immature oocytes were excluded. The fertilisation rate surpassed the minimum competency threshold of the Vienna Consensus (60%), even if below the benchmark value (75%). Clinical pregnancy and live birth rates per oocyte retrieval were 10% and 8%, respectively. Univariate and multivariate analyses failed to identify any predictive factor of fertilisation.

Conclusion

Conventional IVF with one oocyte met Vienna Consensus standards even if it fell short of higher benchmarks.

当只取出一个卵细胞时,采用常规体外受精,而不是卵胞浆内单精子注射:是时候克服非理性恐惧了。
背景:卵胞浆内单精子显微注射(ICSI)的应用目前已超出了男性因素不育症的范围,尤其是在卵母细胞有限的情况下取代了传统的体外受精(IVF),作为受精完全失败的一种预防措施。尽管关于在这种情况下使用常规体外受精的现有研究提供了一些保证,但现有的证据还有些不足,而且 ICSI 是常用的方法。目的:评估在只能取到一个卵母细胞的情况下,常规体外受精是否是一种可行的选择:进行了一项回顾性研究,以评估仅取回一个卵母细胞且伴侣精液正常的女性使用常规体外受精的受精率。该研究旨在评估受精率是否符合公认的试管婴儿实验室绩效指标(维也纳共识)所指出的阈值。临床妊娠率和活产率是次要结果:结果:在 304 个使用传统试管婴儿技术进行单卵母细胞人工授精的周期中,209 个周期实现了正常受精,82 个周期未实现正常受精。13个周期没有成熟卵母细胞。受精率为 69%(95% CI:63-74%),排除未成熟卵母细胞后,受精率增至 72%(95% CI:66-77%)。受精率超过了维也纳共识的最低合格阈值(60%),即使低于基准值(75%)。每次取卵的临床妊娠率和活产率分别为 10%和 8%。单变量和多变量分析未能发现任何受精的预测因素:结论:使用单个卵母细胞的常规体外受精即使达不到更高的基准,也符合维也纳共识标准。
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来源期刊
CiteScore
3.40
自引率
11.80%
发文量
165
审稿时长
4-8 weeks
期刊介绍: The Australian and New Zealand Journal of Obstetrics and Gynaecology (ANZJOG) is an editorially independent publication owned by the Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG) and the RANZCOG Research foundation. ANZJOG aims to provide a medium for the publication of original contributions to clinical practice and/or research in all fields of obstetrics and gynaecology and related disciplines. Articles are peer reviewed by clinicians or researchers expert in the field of the submitted work. From time to time the journal will also publish printed abstracts from the RANZCOG Annual Scientific Meeting and meetings of relevant special interest groups, where the accepted abstracts have undergone the journals peer review acceptance process.
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