Comparison of sibling oocyte outcomes after intracytoplasmic sperm injection and in vitro fertilization in severe teratozoospermic patients in the first cycle
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Summary: To follow up the outcome of sibling oocytes subjected to both conventional in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI) in the first cycles of severe teratozoospermic patients with normal sperm morphology (NSM)≤4%, a total of 1193 sibling metaphase II oocytes (MII) in 85 cycles were randomly allocated into two groups: 588 underwent IVF and 605 ICSI and the embryo outcomes between the two groups were compared. The fertilization rate was significantly higher in the ICSI groups than in the IVF group (p < 0.05) and fertilization failure rate in the ICSI group (2.3%) was lower than in the IVF group (28.2%). Subsequently, the rates of embryo arrest as well as grade 1 and 2 embryo formation before day 3, ≥6 cell embryos on day 3 and blastocyst formation on days 5 and 6, did not differ significantly between the two groups. There was a trend towards a high pregnancy rate cycle in mixed ICSI/IVF embryo transfer (ET) (49.1%). In conclusion, this study showed that in couples with only severe teratozoospermia, there was a benefit in subjecting sibling oocytes to both IVF and ICSI in the first cycle because 24 (28.2%) cycles of total fertilization failure were avoided. Furthermore, despite initially significant higher fertilization rates in ICSI than IVF oocytes, subsequent rates of development from ≥6 cells up to blastocyst stage were the same suggesting that ICSI should be used with caution, as after day 3, ICSI‐derived embryo development was compromised compared with IVF.
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Concerning fertilisation rate, one of the two randomised oocyte cohort studies found no significant impact on fertilisation rates, whereas the other observed higher fertilisation rates with ICSI than with IVF (72.6% vs 44.1%, p < 0.05).
“Concerning fertilisation rate, one of this two found no significant impact on fertilisation rates [104], whereas the other observed higher fertilisation rates with ICSI than with IVF (72.6% vs. 44.1%, p < 0.05) [105].”
From Recommendations for Human Sperm Morphology Assessment in 2025: An Expert Review From the French BLEFCO Group (2026) · cites this paper as [105]
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- Authors
- Kihaile, P. E., Misumi, J., Hirotsuru, K., Kumasako, Y., Kisanga, R. E., & Utsunomiya, T.
- Affiliations
- Muhimbili University of Health and Allied Sciences (TZ)
- Corresponding author
- Kihaile, Paul E.
- Venue
- International Journal of Andrology
- Publisher
- Wiley
- Published
- 2003-01-10
- Volume
- 26
- Issue
- 1
- Pages
- 57-62
- ISSN
- 0105-6263 (ISSN-L)
- 1365-2605
- OpenAlex
- W1990924057
- Cited by
- 36
- References
- 40
- Citations by year
- 2025: 2 · 2022: 1 · 2020: 1 · 2019: 1 · 2018: 1 · 2017: 5 · 2016: 2 · 2015: 3 · 2014: 5 · 2013: 2 · 2012: 3
- FWCI
- 0.68
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- International Journal of Andrology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Reproductive Biology and Fertility
- Health Sciences › Medicine › Reproductive Medicine › Reproductive Health and Technologies
- Health Sciences › Medicine › Reproductive Medicine › Sperm and Testicular Function
- Keywords
- intracytoplasmic sperm injection, in vitro fertilization, sibling oocytes, fertilization rate, fertilization failure, embryonic development, blastocyst development, embryo transfer, pregnancy rate, male infertility
- MeSH terms
- Blastomeres, Cytoplasm, Female, Fertilization in Vitro, Humans, Male, Microinjections, Oligospermia, Oocytes, Pregnancy, Prospective Studies, Spermatozoa
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