The role of ICSI vs. conventional IVF for patients with advanced maternal age-a randomized controlled trial

J Assist Reprod Genet. 2021 Jan;38(1):95-100. doi: 10.1007/s10815-020-01990-5. Epub 2020 Oct 28.

Abstract

Objectives: This study aimed to evaluate the role of intracytoplasmic sperm injection (ICSI) in the treatment of non-male factor infertile patients aged ≥ 39.

Methods: This is a single-center, prospective, randomized controlled clinical trial, between March 2018 and December 2019. Sixty-nine patients were recruited, and sixty patients participated in the study. Their ovaries were randomized prior to the beginning of the ovarian stimulation: the oocytes from one side (n = 257) were allocated to the ICSI (ICSI arm), while those of the contralateral side (n = 258) were allocated to conventional insemination (IVF arm). The fertilization rate per oocyte retrieved, number of zygotes (2PN), and cleavage-stage embryos were assessed and compared between the two study groups.

Results: The average number of zygotes (3.1 vs. 2.7 p = 0.45), the fertilization rate (72.4% vs. 65.1% p = 0.38), the average number of cleavage-stage (2.8 vs. 2.4 p = 0.29), and the average top-quality embryos (TQE) cleavage-stage embryos (1.7 vs. 1.6 p = 0.94) were comparable between the two groups. The TQE rate per randomized oocyte (41.2% vs. 41% p = 0.8) was also similar in both groups.

Conclusions: ICSI does not improve the reproductive outcomes of advanced-age patients undergoing conventional insemination for non-male factor infertility.

Trial registration: NCT03370068.

Keywords: Advanced maternal age; Conventional IVF; ICSI.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Aged
  • Birth Rate
  • Embryo Transfer*
  • Female
  • Fertilization in Vitro / adverse effects
  • Fertilization in Vitro / methods
  • Humans
  • Infertility, Female / genetics*
  • Infertility, Female / pathology
  • Male
  • Maternal Age*
  • Oocytes / growth & development*
  • Oocytes / pathology
  • Ovary / growth & development
  • Ovary / pathology
  • Ovulation Induction
  • Pregnancy
  • Pregnancy Rate
  • Sperm Injections, Intracytoplasmic / adverse effects
  • Sperm Injections, Intracytoplasmic / methods

Associated data

  • ClinicalTrials.gov/NCT03370068