25850
document
Conventional in vitro fertilization versus intracytoplasmic sperm injection in patients with borderline semen : a randomized study using sibling oocytes . OBJECTIVE To determine whether patients with borderline semen should be treated with conventional IVF or intracytoplasmic sperm injection ( ICSI ) . DESIGN Randomized study . SETTING A university medical center in The Netherlands . PATIENT ( S ) One hundred six couples with borderline semen who were undergoing IVF and ICSI on sibling oocytes . INTERVENTION ( S ) Performing IVF and ICSI on sibling oocytes . MAIN OUTCOME MEASURE ( S ) Fertilization and pregnancy rates . RESULT ( S ) One thousand five hundred eighteen oocytes were collected in 106 oocyte retrievals : 849 oocytes were randomly allocated to ICSI , of which 761 were microinjected , and 669 oocytes were randomly assigned to IVF . In 26 of the 106 patients , there was fertilization only after ICSI and not after IVF ( IVF- group ) . The fertilization rate was 51 % ( 92/182 oocytes ) . In 78 patients , there was fertilization after both IVF and ICSI ( IVF+ group ) ; the fertilization rate was 51 % for both the IVF- and ICSI-treated oocytes ( 271/528 oocytes and 334/658 oocytes , respectively ) . In 2 patients , there was no fertilization after either IVF ( 0/6 oocytes ) or ICSI ( 0/9 oocytes ) . Patients of the IVF+ group had a higher total motile sperm count after preparation than did those of the IVF- group . More high-quality embryos were obtained after ICSI in patients of the IVF+ group . In 101 patients , embryo transfer was performed : 26 in the IVF- group and 75 in the IVF+ group . No significant differences were found with regard to pregnancy rates between those two groups : pregnancy rates were 54 % in the IVF- group and 48 % in the IVF+ group . CONCLUSION ( S ) Performing ICSI on at least some of the oocytes will avoid unnecessary fertilization failure in patients with borderline semen : in this study , 26 of 104 cycles ( 25 % ) were rescued by ICSI .
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Intervention_Other
Conventional in vitro fertilization
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Intervention_Physical
intracytoplasmic sperm injection
25853
Intervention_Physical
conventional IVF
25854
Intervention_Physical
intracytoplasmic sperm injection ( ICSI )
25855
Intervention_Physical
IVF
25856
Intervention_Physical
ICSI
25857
Intervention_Physical
IVF
25858
Intervention_Physical
ICSI
25859
Intervention_Other
microinjected
25860
Intervention_Physical
IVF
25861
Intervention_Physical
ICSI
25862
Intervention_Physical
IVF
25863
Intervention_Physical
IVF
25864
Intervention_Physical
ICSI
25865
Intervention_Physical
IVF-
25866
Intervention_Physical
ICSI-treated
25867
Intervention_Physical
IVF
25868
Intervention_Physical
ICSI
25869
Intervention_Physical
ICSI
25870
Intervention_Physical
IVF+
25871
Intervention_Physical
IVF-
25872
Intervention_Physical
IVF+
25873
Intervention_Physical
IVF-
25874
Intervention_Physical
IVF+
25875
Intervention_Physical
ICSI
25876
Intervention_Physical
ICSI
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Outcome_Physical
Fertilization and pregnancy rates .
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Outcome_Other
fertilization rate
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Outcome_Physical
total motile sperm count
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Outcome_Physical
high-quality embryos
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Outcome_Physical
embryo transfer
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Outcome_Physical
pregnancy rates
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Outcome_Physical
fertilization failure
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Participant_Condition
in patients with borderline semen :
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Participant_Condition
patients with borderline semen
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Participant_Sample-size
One hundred six couples
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Participant_Condition
borderline semen
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Participant_Sample-size
In 78 patients
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Participant_Sample-size
2 patients
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Participant_Sample-size
101 patients
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Participant_Condition
patients with borderline semen