Table 5 Studies which examine the difference between IVF and ICSI procedures and relationship of cytoplasmic fragmentation

Frattarelli et al.

2000

Intracytoplasmic sperm injection increases embryo fragmentation without affecting clinical outcome

Clinical trial

253 patients (71 ICSI, 182 IVF), total of 992 graded embryos compared (289 embryos ICSI, 70 embryos IVF).

Day-3 embryos.

37 years of age or less; mean age for ICSI group 32.7 years (SD = 3.3); mean age for IVF 32.3 years (SD = 3.3).

Stimulation with variety of stim protocols (GnRH analogue) or oral contraceptive pill down regulation followed by stimulation with exogenous gonadotropins or concomitant initiation of GnRH-a and exogenous gonadotropins ("flare" cycles). Transvaginal ultrasound follicular aspiration 34-36 hours after injection with 10,000 units of hCG.

Embryo morphology and degree of fragmentation.

Hsu et al.

1999

Embryo implantation in in vitro fertilization and intracytoplasmic sperm injection: impact of cleavage status, morphology grade, and number of embryos transferred

Retrospective

Total of 422 patients. 211 consecutive couples undergoing ICSI who were matched with 211 couples undergoing IVF therapy during the same time frame. 1,737 embryos transferred available for analysis.

Day-3 embryos.

Controlled ovarian hyperstimulation by combination of GnRH agonist (Lupron) and FSH (Metrodin or Fertinex). Transvaginal follicular aspiration 34-35 hours after hCG administration.

Day-3 embryo quality as judged by the number of blastomeres and morphology scoring.

Garello et al.

1999

Pronuclear orientation, polar body placement, and embryo quality after intracytoplasmic sperm injection and in-vitro fertilization: further evidence for polarity in human oocytes?

Prospective

251 two pronuclear (2PN) embryos (124 ICSI, 127 IVF) from 64 patients studied.

Morphologic grade of day-2 embryos recorded.

IVF: 33.6 ± 5.4 years (range, 24–46 years).

ICSI: 33.3 ± 4.3 years (range, 26–45 years).

Total: 33.5 ± 5.0 (24–46 years).

GnRH from day 21 of menstrual cycle, 2 day withdrawal bleed by stimulation with FSH, ultrasound guided retrieval 36 hrs after hCG 10,000 U.

Embryo morphology.

Yoeli et al.

2008

Comparison of embryo quality between intracytoplasmic sperm injection and in vitro fertilization in sibling oocytes

Prospective

177 patients, 36 with male-factor infertility and 141 with low fertilization rate in previous standard IVF cycle.

Total of 3,006 oocytes were retrieved; mean number of oocytes retrieved per patient was 17.1 +/- 7.2.

Day-2 and day-3 embryos.

Mean age of 31.9 +/- 5.2 years (range, 21 - 44 years).

Stim protocol not described.

10,000 IU dose of hCG injected when at least two follicles reached diameter of 18 mm, US guided follicular aspiration 34-36 hours afer hCG.

Embryo quality.

Ruiz et al.

1997

The role of in vitro fertilization and intracytoplasmic sperm injection in couples with unexplained infertility after failed intrauterine insemination

Prospective

70 couples with unexplained infertility (n=63) and mild endometriosis (n=7) undergoing IVF after four failed controlled ovarian stimulation and IUI cycles.

Cleavage stage embryos.

Mean age 31.9 +/- 0.4 years.

Protocols for standard IVF and ICSI procedures as documented in previous work.

Fertilization, cleavage, embryo quality in IVF and ICSI inseminated oocytes.