scholarly journals Development of ICSI

Reproduction ◽  
2018 ◽  
Vol 156 (1) ◽  
pp. F51-F58 ◽  
Author(s):  
C L O’Neill ◽  
S Chow ◽  
Z Rosenwaks ◽  
G D Palermo
Keyword(s):  
Pregnancy Rate ◽  
Human Body ◽  
Assisted Reproductive Techniques ◽  
Semen Parameters ◽  
Male Factor Infertility ◽  
Fertilization Failure ◽  
Male Factor ◽  
Reproductive Techniques

The first conception outside of the human body that led to the birth of Louise Brown was a tremendous accomplishment, which opened the door to the utilization of assisted reproductive techniques globally. This brought the understanding that accomplishing life in a dish required several steps, the most obvious being the timing and characteristics of fertilization. It soon became obvious in the 1980s that the most disappointing phenomenon was unexpected and complete fertilization failure. Among the approaches that were attempted to treat male factor infertility, ICSI surfaced as the technique that brought the ratio of the gametes to 1:1 and was also able to grant consistent fertilization and a higher pregnancy rate. ICSI has now been implemented for a quarter of a century, proving itself as the ultimate technique utilizing ejaculated spermatozoa independent of the semen parameters and is the sole insemination method to be used with surgically retrieved spermatozoa. There are currently various indications for ICSI that are widely adopted, rendering it the most popular insemination method worldwide. The reliability of ICSI ensures its employment in upcoming techniques involving in vitro spermatogenesis and neogametogenesis.

scholarly journals The pioneering of intracytoplasmic sperm injection: historical perspectives

Reproduction ◽  
2017 ◽  
Vol 154 (6) ◽  
pp. F71-F77 ◽  
Author(s):  
Zev Rosenwaks ◽  
Nigel Pereira
Keyword(s):  
Intracytoplasmic Sperm Injection ◽  
Scientific Work ◽  
Semen Parameters ◽  
Male Factor Infertility ◽  
Fertilization Failure ◽  
Male Factor ◽  
Live Births ◽  
Historical Perspectives ◽  
Mammalian Fertilization

Intracytoplasmic sperm injection (ICSI) has often been heralded as a ground-breaking technique that has transformed the treatment of couples with infertility. By injecting a single spermatozoon into the cytoplasm of the oocyte, ICSI bypasses the zona pellucida and increases the chances of fertilization and subsequent embryo development, independent of semen parameters. Ever since the first live births using ICSI were reported in 1992, ICSI has become the mainstay of treating male factor infertility as well as overcoming fertilization failure associated with conventional in vitro insemination. Today, ICSI is utilized in nearly 66% of all assisted reproductive treatments worldwide and has resulted in the birth of millions of babies. The primary goal of this review is to provide historical perspectives about the pioneering of ICSI. We begin by highlighting the scientific work of early investigators who elucidated the mechanisms central to mammalian fertilization. Furthermore, we briefly discuss how these findings contributed to the development of IVF for the treatment of infertility. We then emphasize the shortcomings of IVF in treating severe forms of male factor infertility and enumerate the micromanipulation techniques that were developed to circumvent these shortcomings. Finally, we indicate how the inadequacies of these micromanipulation techniques lead to the inception, application and popularity of ICSI.

Microinjection: choice of embryo transfer technique

1994 ◽  
Vol 6 (1) ◽  
pp. 57 ◽  
Author(s):  
RI McLachlan ◽  
G Fuscaldo ◽  
I Calderon ◽  
O Lacham-Kaplan ◽  
C Poulos ◽  
...  
Keyword(s):  
Pregnancy Rate ◽  
Fallopian Tube ◽  
Controlled Trial ◽  
Initial Study ◽  
Gamete Intrafallopian Transfer ◽  
Male Factor Infertility ◽  
Motile Sperm ◽  
Male Factor ◽  
Vitro Fertilization

Subzonal sperm microinjection (SUZI) is indicated in severe oligoasthenozoospermia, in which the total count of motile sperm is inadequate for in vitro fertilization (IVF), and in cases with repeated failure of fertilization. Sperm for microinjection are selected following centrifugation on a Percoll gradient and stimulation with pentoxifylline and 2-deoxyadenosine. Motile sperm (2-10 per egg) are injected into the perivitelline space and fertilized oocytes are then cultured for two days prior to transfer into the Fallopian tube (tubal embryo stage transfer, TEST) or uterus. During 1992, SUZI results showed a total fertilization rate of 30% (19% were 2 pronuclear, 11% were polyspermic), a transfer rate of 55% and pregnancy rates of 15.2% per transfer and 8.3% per cycle. Recent pregnancy data in mild-moderate male factor infertility showed that gamete intrafallopian transfer (GIFT) results were consistently superior to TEST or IVF, suggesting a beneficial effect of the tubal environment on fertilization and early embryonic development. Accordingly, the combination of SUZI followed by the immediate transfer of injected oocytes into the Fallopian tube, the MIFT procedure, was explored. An initial study of 21 consecutive microinjection candidates showed a clinical pregnancy rate of 24% per cycle. Information regarding fertilization and polyspermy rates was available from supernumerary oocytes in 90% of patients. A randomized, controlled trial comparing MIFT with SUZI or TEST in severe male factor infertility is required to confirm the improved pregnancy rate in MIFT cycles.

scholarly journals The Impact of Intracytoplasmic Sperm Injection in Non-Male Factor Infertility—A Critical Review

2021 ◽  
Vol 10 (12) ◽  
pp. 2616
Author(s):  
Tanya L. Glenn ◽  
Alex M. Kotlyar ◽  
David B. Seifer
Keyword(s):  
Intracytoplasmic Sperm Injection ◽  
Live Birth Rate ◽  
Fertilization Rate ◽  
Male Factor Infertility ◽  
Fertilization Failure ◽  
Male Factor ◽  
Vitro Fertilization ◽  
Total Fertilization Failure ◽  
The Impact

Intracytoplasmic sperm injection (ICSI) was originally designed to overcome barriers due to male factor infertility. However, a surveillance study found that ICSI use in non-male factor infertility increased from 15.4% to 66.9% between 1996 and 2012. Numerous studies have investigated fertilization rate, total fertilization failure, and live birth rate per cycle (LBR), comparing the use of ICSI versus conventional in vitro fertilization (IVF) for non-male factor infertility. The overwhelming conclusion shows no increase in fertilization rate or LBR per cycle with the use of ICSI for non-male factor infertility. The overuse of ICSI is likely related to the desire to avoid a higher rate of total fertilization failure in IVF. However, data supporting the benefit of using ICSI for non-male factor infertility is lacking, and 33 couples would need to be treated with ICSI unnecessarily to avoid one case of total fertilization failure. Such practice increases the cost to the patient, increases the burden on embryologist’s time, and is a misapplication of resources. Additionally, there remains conflicting data regarding the safety of offspring conceived by ICSI and potential damage to the oocyte. Thus, the use of ICSI should be limited to those with male factor infertility or a history of total fertilization factor infertility due to uncertainties of potential adverse impact and lack of proven benefit in non-male factor infertility.

Pregnancy Success Rates by Different Assisted Reproductive Techniques in Tubal, Ovarian, and Sperm Disorders

2020 ◽  
Vol 6 (3) ◽  
pp. 187-192
Author(s):  
Zeinab Hajaliakbari Hafezabad ◽  
◽  
Milad Ahmadi Gohari ◽  
Faezeh Kashi ◽  
◽  
...  
Keyword(s):  
Pregnancy Rate ◽  
Fertility Rate ◽  
Assisted Reproductive Techniques ◽  
World Health ◽  
Success Rates ◽  
Tubal Infertility ◽  
Vitro Fertilization ◽  
Significant Difference ◽  
Reproductive Techniques

Background: Assisted Reproductive Techniques (ART) have been used for addressing numerous causes of infertility. However, it remains unclear which kind of these methods are best for various infertility types. Accordingly, this study aimed at determining pregnancy success rates by different ART in tubal, ovarian, and sperm disorders. Methods: The present descriptive retrospective study used the records of individuals who had referred to the Infertility Center of Kerman University of Medical Sciences from March 2016 to December 2017. All subjects underwent Intracytoplasmic Sperm Injection (ICSI) and In Vitro Fertilization (IVF). The sperm parameters were assessed based on the criteria of the World Health Organization (WHO) for determining the causes of male infertility. The data were documented and compared with the criteria of the WHO. Then, they were analyzed by analysis of variance, Paired Samples t-test, Chi-squared, or Fisher’s Exact tests using SPSS. Results: The overall Mean±SD fertility rate in IVF and ICSI was 4.28±2.87 and 3.62±2.54, respectively and the difference was not significant (t=1.02, P=0.319). There was a significant difference in the fertility rate due to tubal infertility (P=0.018) between ICSI and IVF; the fertility rate in the IVF method was significantly higher than that of the ICSI. The pregnancy rate in the freeze method was higher than those of the other methods (P<0.001). This discrepancy was also found in all causes of infertility. There was no significant difference in the disorders of sperm and the result of two methods (IVF/ICSI). Conclusion: The obtained results suggested that in the freeze method, the pregnancy rate was higher than other approaches; this discrepancy was found in all the causes of infertility. It is suggested that frozen-thawed embryo transfer be used in infertile individuals. This is because it increases the success rate of pregnancy and prevents complications due to the repeated use of infertility treatments and exorbitant treatment costs.

scholarly journals Controlled ovarian stimulation should not be preferred for male infertility treated with intrauterine insemination: a retrospective study

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Yan Tang ◽  
Qian-Dong He ◽  
Ting-Ting Zhang ◽  
Jing-Jing Wang ◽  
Si-Chong Huang ◽  
...  
Keyword(s):  
Ectopic Pregnancy ◽  
Pregnancy Rate ◽  
Ovarian Stimulation ◽  
Intrauterine Insemination ◽  
Multiple Pregnancy ◽  
Clinical Pregnancy ◽  
Male Factor Infertility ◽  
Male Factor ◽  
Ovulatory Follicles ◽  
Multiple Pregnancy Rate

Abstract Background Some studies have stated that intrauterine insemination (IUI) with controlled ovarian stimulation (COS) might increase the pregnancy rate, while others suggest that IUI in the natural cycle (NC) should be the first line of treatment. It remains unclear whether it is necessary to use COS at the same time when IUI is applied to treat isolated male factor infertility. Thus, we aimed to investigate efficacy of IUI with COS for isolated male factor infertility. Methods A total of 601 IUI cycles from 307 couples who sought medical care for isolated male factor infertility between January 2010 and February 2020 were divided into two groups: NC-IUI and COS-IUI. The COS-IUI group was further divided into two subgroups according to the number of pre-ovulatory follicles on the day of HCG: cycles with monofollicular development (one follicle group) and cycles with at least two pre-ovulatory follicles (≥ 2 follicles group). The IUI outcomes, including clinical pregnancy, live birth, spontaneous abortion, ectopic pregnancy, and multiple pregnancy rates were compared. Results The clinical pregnancy, live birth, spontaneous abortion, and ectopic pregnancy rates were comparable between the NC-IUI and COS-IUI group. Similar results were also observed among the NC-IUI, one follicle, and ≥ 2 follicles groups. However, with respect to the multiple pregnancy rate, a trend toward higher multiple pregnancy rate was observed in the COS-IUI group compared to the NC-IUI group (8.7% vs. 0, P = 0.091), and a significant difference was found between the NC-IUI and ≥ 2 follicles group (0 vs. 16.7%, P = 0.033). Conclusion In COS cycles, especially in those with at least two pre-ovulatory follicles, the multiple pregnancy rate increased without a substantial gain in overall pregnancy rate; thus, COS should not be preferred in IUI for isolated male factor infertility. If COS is required, one stimulated follicle and one healthy baby should be the goal considering the safety of both mothers and foetuses.

scholarly journals Should rescue ICSI be re-evaluated considering the deferred transfer of cryopreserved embryos in in-vitro fertilization cycles? A systematic review and meta-analysis

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Alessio Paffoni ◽  
Marco Reschini ◽  
Valerio Pisaturo ◽  
Cristina Guarneri ◽  
Simone Palini ◽  
...  
Keyword(s):  
In Vitro Fertilization ◽  
Pregnancy Rate ◽  
Embryo Transfer ◽  
Implantation Rate ◽  
Clinical Pregnancy ◽  
Frozen Embryo Transfer ◽  
Fertilization Failure ◽  
Vitro Fertilization ◽  
Rescue Icsi

Abstract Background Total fertilization failure represents a particularly frustrating condition for couples undergoing in vitro fertilization. With the aim of reducing the occurrence of total fertilization failure, intracytoplasmic sperm injection (ICSI) has become the first choice over conventional in vitro fertilization (IVF) procedures although evidence of improved results is still debated and its use in couples without male factor infertility is not recommended. Among the strategies potentially useful to promote the use of conventional IVF, we herein call attention to the late rescue ICSI, which consists in performing ICSI after 18–24 h from conventional insemination on oocytes that show no signs of fertilization. This treatment has however been reported to be associated with a low success rate until recent observations that embryos derived from late rescue ICSI may be transferred after cryopreservation in a frozen-thawed cycle with improved results. The aim of the present study was to assess whether frozen embryos deriving from rescue ICSI performed about 24 h after conventional IVF may represent a valuable option for couples experiencing fertilization failure. Methods A systematic review on the efficacy of late rescue ICSI was performed consulting PUBMED and EMBASE. Results Including twenty-two original studies, we showed that clinical pregnancy rate per embryo transfer and implantation rate obtainable with fresh embryo transfers after rescue ICSI are not satisfactory being equal to 10 and 5%, respectively. The transfer of cryopreserved rescue ICSI embryos seems to offer a substantial improvement of success rates, with pregnancy rate per embryo transfer and implantation rate equal to 36 and 18%, respectively. Coupling rescue ICSI with frozen embryo transfer may ameliorate the clinical pregnancy rate for embryo transfer with an Odds Ratio = 4.7 (95% CI:2.6–8.6). Conclusion Results of the present review support the idea that r-ICSI coupled with frozen embryo transfer may overcome most of the technical and biological issues associated with fresh transfer after late r-ICSI, thus possibly representing an efficient procedure for couples experiencing fertilization failure following conventional IVF cycles. Trial registration Prospero registration ID: CRD42021239026.

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