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- Title
RESCUE ICSI: CAN IT PREVENT FROM UNFERTILIZATION IN IVF?
- Authors
Chen, Z. J.
- Abstract
Objective: With the application of Short IVF insemination -- brief gamete contact of 1 to 4 h, combined with second polar body extrusion analysis, rescue ICSI can be applied earlier after insemination. The present study was designed to assess the value of early rescue ICSI applied 5h after insemination, and to explore the rule of second polar body extrusion in order to apply rescue ICSI as earlier as possible. Materials and Methods: The oocytes of all the women undergoing IVF were co-incubated with their own husbands' sperms for 3 hours. The second polar body of each oocyte was observed 3, 4 and 5 hours after insemination. Only the oocytes that extruded the second polar body were regarded as fertilized. If less than 70% oocytes from one patient extruded the second polar body 5 h after insemination, the oocytes with only the first polar body would be performed early rescue ICSI. Conventional ICSI cycles and IVF cycles undergone normal fertilization were setted as control group. The second polar body extrusion result at different time point, fertilization result, high quality embryo rate, clinical pregnancy rate and implantation rate were collected for analysis. Results: There was no significant difference (P > 0.05) between early rescue ICSI and conventional ICSI cycles in the clinic pregnancy rate (62 of 154, 40.24%vs.59 of 152 38.82%), and there was also no significant difference (P > 0.05) among early rescue cycles, conventional ICSI cycles and normal fertilized IVF cycles in implant rate (86 of 346, 24.86% vs.77 of 335, 22.99% vs.111 of 455, 24.39%). The ICSI part of rescue cycles was significantly higher (P < 0.05) than IVF part of rescue cycles in fertilization rate (652 of 703, 92.75% vs. 369 of 450, 82.00%) and 2PN rate (562 of 703, 79.94% vs. 313 of 450, 69.56%). The high quality embryo rate of ICSI part of rescue cycles significantly lower (P < 0.05) compared to IVF part of rescue cycles, conventional ICSI cycles and normal IVF cycles (272 of 562, 48.40% vs. 181 of 313, 57.83% vs. 725 of 1221, 59.38% vs. 1830 of 2851, 64.19%). And there was also significant difference (p < 0.05) between IVF part of rescue cycles and normal IVF cycles in high quality embryo rate (181 of 313, 57.83% vs. 830 of 2851, 64.19%). Only 5.97% (108/1810), 21.22% (384/1810) and 26.90% (487/1810) of oocytes in rescue cycles extrude second polar body 3 h, 4 h and 5 h after insemination respectively, significantly lower (P < 0.01) than the rate in normal IVF cycles (54.15%, 85.90% and 94.62% respectively). To the 43 cycles that no oocytes extruded second polar body 4 h after insemination, rescue ICSI be applied to all MII oocytes in 40(90.02%) cycles and part of MII oocytes in 43(100%) cycles. Rescue ICSI be applied to all MII oocytes in 40(100%) cycles that no oocytes extruded second polar body 5 h after insemination. Conclusions: It is possible to design a strategy combining short IVF insemination, early fertilization evaluation, and rescue ICSI on eggs that failed to fertilize after conventional IVF.
- Subjects
FERTILIZATION in vitro; REPRODUCTIVE technology; GAMETES; EMBRYOLOGY; OVUM
- Publication
Reproductive BioMedicine Online (Reproductive Healthcare Limited), 2010, Vol 20, pS26
- ISSN
1472-6483
- Publication type
Article
- DOI
10.1016/S1472-6483(10)62482-0