Obstet Gynecol Sci.  2015 May;58(3):217-222. 10.5468/ogs.2015.58.3.217.

Embryonic development in human oocytes fertilized by split insemination

• Kim MS
• Kim J
• Youm HW
• Park JY
• Choi HY
• Jee BC

• KMID: 2148934
• DOI: http://doi.org/10.5468/ogs.2015.58.3.217

Abstract

OBJECTIVE
To compare the laboratory outcomes of intracytoplasmic sperm injection (ICSI) and conventional insemination using sibling oocytes in poor prognosis IVF cycles where ICSI is not indicated.
METHODS
Couples undergoing IVF with following conditions were enrolled: history of more than 3 years of unexplained infertility, history of > or =3 failed intrauterine insemination, leukocytospermia or wide variation in semen analysis, poor oocyte quality, or > or =50% of embryos had poor quality in previous IVF cycle(s). Couples with severe male factor requiring ICSI were excluded. Oocytes were randomly assigned to the conventional insemination (conventional group) or ICSI (ICSI group). Fertilization rate (FR), total fertilization failure, and embryonic development at day 3 and day 5 were assessed.
RESULTS
A total of 309 mature oocytes from 37 IVF cycles (32 couples) were obtained: 161 were assigned to conventional group and 148 to ICSI group. FR was significantly higher in the ICSI group compared to the conventional group (90.5% vs. 72.7%, P<0.001). Total fertilization failure occurred in only one cycle in conventional group. On day 3, the percentage of cleavage stage embryos was higher in ICSI group however the difference was marginally significant (P=0.055). In 11 cycles in which day 5 culture was attempted, the percentage of blastocyst (per cleaved embryo) was significantly higher in the ICSI group than the conventional group (55.9% vs. 25.9%, P=0.029).
CONCLUSION
Higher FR and more blastocyst could be achieved by ICSI in specific circumstances. Fertilization method can be tailored accordingly to improve IVF outcomes.

Keyword

Blastocyst; Fertilization; Fertilization in vitro; Intracytoplasmic sperm injection; Split insemination

MeSH Terms

Blastocyst
Embryonic Development*
Embryonic Structures
Family Characteristics
Female
Fertilization
Fertilization in Vitro
Humans
Infertility
Insemination*
Male
Oocytes*
Pregnancy
Prognosis
Semen Analysis
Siblings
Sperm Injections, Intracytoplasmic

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