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

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.

Chinese abstract

早期卵丘细胞去除和早期卵胞浆内单精子显微注射补救对受精失败高风险患者妊娠结局的影响

摘要

目的：本项回顾性研究的目的是评估在体外受精（IVF）过程中, 受精失败高风险患者的早期卵丘细胞去除和早期卵胞浆内单精子显微注射（ICSI）补救的临床预后。

方法：纳入2014年1月至2016年12月期间的5518例患者, 其中505对受精率> 30％的夫妇采用短期授精为短期IVF组, 102对检测到完全受精失败（TFF）的夫妇采用早期补救ICSI方案（R-ICSI组）, 4911对夫妇采用过夜精卵共孵育的常规IVF方法（传统IVF组）。分析三组患者的临床预后。

结果：三组胚胎着床率（传统IVF组, 短期IVF组和R-ICSI组分别为40.34％, 39.78％和42.42％）具有可比性。传统IVF组, 短期IVF组和R-ICSI组的临床妊娠率分别为57.95％, 57.03％和60.78％, 三组间差异无统计学意义。

结论：本研究表明, 短期授精对人类IVF的临床预后并无不利影响, 且可以预防受精失败高风险患者出现TFF合并早期补救ICSI, 从而获得可接受的妊娠结局。

关键词: 完全受精失败, 短期授精, 早期补救卵胞浆内单精子显微注射, 临床预后

Keywords:

• Total fertilization failure
• short insemination
• early rescue ICSI
• clinical outcomes

Acknowledgements

The study was performed under the auspices of the IVF unit of the Third Affiliated Hospital of Guangzhou Medical University.

This study was supported by the National Natural Science Foundation of China (NSFC, 81501327) and Scientific Research Program of The Third Affiliated Hospital of Guangzhou Medical University (2017B04).

Disclosure statement

No potential conflict of interest was reported by the authors.