Pregnancy and neonatal outcomes of intracytoplasmic sperm injection versus in vitro fertilization in fresh cycles of women with advanced maternal age and nonmale factor infertility: A cross-sectional study.

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.