Neonatal outcomes after early rescue intracytoplasmic sperm injection: an analysis of a 5-year period.

OBJECTIVE To evaluate the safety and efficacy of early rescue intracytoplasmic sperm injection (ICSI). DESIGN Retrospective cohort study. SETTING Teaching hospital. PATIENT(S) There were 13,232 ovarian stimulation cycles (IVF, n = 9,631; ICSI, n = 2,871; early rescue ICSI, n = 730) that resulted in the delivery of 5,001 babies (IVF, n = 3,670; ICSI, n = 1,095; early rescue ICSI, n = 246) from August 2008 to August 2013. INTERVENTION(S) Early rescue ICSI. MAIN OUTCOME MEASURE(S) Clinical pregnancy rates, neonatal outcomes, and congenital birth defects were analyzed. RESULT(S) The early rescue ICSI cycles did not seem to have a negative effect on the clinical pregnancy rate (43.42%) when IVF cycles (45.33%) were compared with ICSI cycles (44.39%). In the early rescue ICSI group, a total of 254 clinical pregnancies were achieved: 197 (33.67%) live births, 38 (6.49%) miscarriages, 2 (0.79%) induced abortions, 3 (1.18%) fetal deaths, and 4 pregnancies (1.57%) without completion at follow-up. Overall, the multiple gestations, the delivery method, mean gestational age, preterm deliveries, mean birth weight, and rate of congenital birth defects of the early rescue ICSI group were similar to those in the conventional IVF and ICSI groups. CONCLUSION(S) Early rescue ICSI had similar clinical pregnancy rates when compared with conventional IVF and ICSI, in addition to the delivery of healthy children. The clinical evidence from the early rescue ICSI group did not show an elevated rate of malformations. Early rescue ICSI seems to be a safe alternative method for individuals with total fertilization failure or near total fertilization failure when compared with conventional IVF treatment.

[1]  Y. Qiao,et al.  Effect of coincubation time of sperm-oocytes on fertilization, embryonic development, and subsequent pregnancy outcome , 2012, Systems biology in reproductive medicine.

[2]  R. Casper,et al.  Ongoing twin pregnancy after rescue intracytoplasmic sperm injection of unfertilized abnormal oocytes. , 2008, Fertility and Sterility.

[3]  P. Navarro,et al.  Comparative Analysis of the Spindle of Fresh In Vivo-Matured Human Oocytes Through Polarized Light and Confocal Microscopy , 2014, Reproductive Sciences.

[4]  C. Racowsky,et al.  Diagnosing cellular defects in an unexplained case of total fertilization failure. , 2010, Human reproduction.

[5]  M. Muñoz,et al.  Polarized light microscopy in mammalian oocytes. , 2010, Reproduction in domestic animals = Zuchthygiene.

[6]  Shalin B. Mehta,et al.  Polarized light microscopy in reproductive and developmental biology , 2015, Molecular reproduction and development.

[7]  W. Liu,et al.  Effects of cumulus cells removal after 6 h co-incubation of gametes on the outcomes of human IVF , 2011, Journal of Assisted Reproduction and Genetics.

[8]  Z. Nagy,et al.  Intracytoplasmic single sperm injection of 1-day-old unfertilized human oocytes. , 1993, Human reproduction.

[9]  Bo Huang,et al.  Progesterone elevation on the day of HCG administration may affect rescue ICSI. , 2014, Reproductive biomedicine online.

[10]  Z. Nagy,et al.  Time-course of oocyte activation, pronucleus formation and cleavage in human oocytes fertilized by intracytoplasmic sperm injection. , 1994, Human reproduction.

[11]  J. Mandelbaum,et al.  Timing of in-vitro fertilization of cumulus-free and cumulus-enclosed human oocytes. , 1986, Human reproduction.

[12]  G. Wright,et al.  Reinsemination by intracytoplasmic sperm injection of 1-day-old oocytes after complete conventional fertilization failure. , 1997, Fertility and sterility.

[13]  D. Payne,et al.  Preliminary observations on polar body extrusion and pronuclear formation in human oocytes using time-lapse video cinematography. , 1997, Human reproduction.

[14]  E. Lombardi,et al.  Live birth and normal 1-year follow-up of a baby born after transfer of cryopreserved embryos from rescue intracytoplasmic sperm injection of 1-day-old oocytes. , 2003, Fertility and sterility.

[15]  A. Yuzpe,et al.  Rescue intracytoplasmic sperm injection (ICSI)-salvaging in vitro fertilization (IVF) cycles after total or near-total fertilization failure. , 2000, Fertility and sterility.

[16]  H. Holzer,et al.  Spindle examination in unfertilized eggs using the polarization microscope can assist rescue ICSI. , 2013, Reproductive biomedicine online.

[17]  Kazuhiro Kikuchi,et al.  Oocyte aging: cellular and molecular changes, developmental potential and reversal possibility. , 2009, Human reproduction update.

[18]  Christopher Chen,et al.  Rescue ICSI of oocytes that failed to extrude the second polar body 6 h post-insemination in conventional IVF. , 2003, Human reproduction.

[19]  J. Tesarik.  Associate Editor's commentary: Rescue ICSI revisited , 2003 .

[20]  M. Diamond,et al.  The optimal time for intracytoplasmic sperm injection in the human is from 37 to 41 hours after administration of human chorionic gonadotropin. , 2004, Fertility and sterility.

[21]  Lei Jin,et al.  Is frozen embryo transfer cycle associated with a significantly lower incidence of ectopic pregnancy? An analysis of more than 30,000 cycles. , 2014, Fertility and sterility.

[22]  W. Kuczyński,et al.  Rescue ICSI of unfertilized oocytes after IVF. , 2002, Human reproduction.

[23]  Ping Liu,et al.  Synchronization between embryo development and endometrium is a contributing factor for rescue ICSI outcome. , 2012, Reproductive biomedicine online.

[24]  E. Shalev,et al.  Rescue intracytoplasmic sperm injection: a systematic review. , 2014, Fertility and sterility.

[25]  A. Revelli,et al.  Polarized light microscopy-detectable structures of human oocytes and embryos are related to the likelihood of conception in IVF , 2012, Journal of Assisted Reproduction and Genetics.

[26]  B. Benzacken,et al.  Should all embryos from day 1 rescue intracytoplasmic sperm injection be transferred during frozen-thawed cycles? , 2010, Fertility and sterility.

[27]  A. Sjögren,et al.  Intracytoplasmic sperm injection of 1 day old oocytes after fertilization failure. , 1995, Human reproduction.