Effect of early cumulus cells removal and early rescue ICSI on pregnancy outcomes in high-risk patients of fertilization failure

Gynecol Endocrinol. 2018 Aug;34(8):689-693. doi: 10.1080/09513590.2018.1433159. Epub 2018 Feb 15.

Abstract

Objective: The objective of this retrospective study was to evaluate clinical outcomes of early cumulus cells removal and early rescue intracytoplasmic sperm injection (ICSI) in high-risk patients of fertilization failure during human in vitro fertilization (IVF).

Methods: A total of 5,518 patients were enrolled between January 2014 to December 2016. Of which 505 couples performed short insemination with >30% fertilization rate were included in short-term IVF group, 102 patients detected total fertilization failure (TFF) were treated with early rescue ICSI (R-ICSI group), and 4911 couples underwent conventional IVF with overnight co-incubation of gametes (traditional IVF group). The clinical outcomes were analyzed among the three groups.

Results: The embryo implantation rates (40.34%, 39.78% and 42.42% for traditional, short-term IVF and R-ICSI groups, respectively) were comparable in the three groups. The clinical pregnancy rates among traditional IVF group, short-term IVF group and R-ICSI group were 57.95%, 57.03% and 60.78%, respectively, and the difference among three groups didn't reach significance.

Conclusion: The present study indicated that short insemination had no detrimental effects on clinical outcomes in human IVF and could prevent the occurrence of TFF combined with early rescue ICSI for high-risk patients of fertilization failure, which attained acceptable pregnancy outcomes.

Keywords: Total fertilization failure; clinical outcomes; early rescue ICSI; short insemination.

MeSH terms

  • Adult
  • Embryo Implantation*
  • Embryonic Development*
  • Female
  • Humans
  • Male
  • Pregnancy
  • Pregnancy Rate
  • Retrospective Studies
  • Sperm Injections, Intracytoplasmic / methods*
  • Sperm Injections, Intracytoplasmic / statistics & numerical data