4.6 Article

Safety of early cumulus cell removal combined with early rescue ICSI in the prevention of fertilization failure

Journal

REPRODUCTIVE BIOMEDICINE ONLINE
Volume 47, Issue 2, Pages -

Publisher

ELSEVIER SCI LTD
DOI: 10.1016/j.rbmo.2023.04.005

Keywords

Birth defects; Early cumulus cell removal; Fertilization failure; Neonatal outcome; Pregnancy outcome; Rescue intracytoplasmic sperm injection

Ask authors/readers for more resources

This retrospective study analyzed the clinical outcomes and safety implications of early cumulus cell removal combined with early rescue ICSI in preventing fertilization failure. The results showed that early cumulus cell removal did not have a significant impact on fertilization, pregnancy, neonates, or birth defects. Compared to conventional ICSI, early rescue ICSI had similar rates of fertilization and pregnancy, but a higher polyploidy rate and lower high-quality embryo rate.
Research question What are the clinical outcomes and safety implications of early cumulus cell removal after short-term insemination combined with early rescue intracytoplasmic sperm injection (ICSI) in preventing fertilization failure? Design In this retrospective study, a total of 14,360 cycles were divided into four groups based on insemination method and fertilization ability: conventional IVF group (n = 5519); early cumulus cell removal group (n = 4107); conventional ICSI group (n = 4215); and early rescue ICSI group (where failed or low fertilization was predicted, n = 519). Fertilization outcomes, pregnancy outcomes, neonatal outcomes and birth defects were analysed by comparing the early cumulus cell removal group with the conventional IVF group, and the early rescue ICSI group with the conventional ICSI group. Results There were no significant differences in the outcomes of fertilization, pregnancy, neonates or birth defects between the conventional IVF group and the early cumulus cell removal group (P > 0.05). When compared with the conventional ICSI group, the early rescue ICSI group had similar rates of two pronuclei (2PN) at fertilization, clinical pregnancy, miscarriage, ectopic pregnancy, live birth, sex, mean gestational age, very low birthweight, macrosomia and birth defects (P > 0.05) but a higher polyploidy rate, lower high-quality embryo rate (both P < 0.001), lower twin pregnancy rate (P < 0.01), lower rate of low birthweight, and a higher rate of normal birthweight (both P = 0.024). Conclusions Early cumulus cell removal combined with early rescue ICSI led to good pregnancy and neonatal outcomes without an increase in birth defects. This approach could therefore be an effective and safe method for patients with fertilization failure in conventional IVF.

Authors

I am an author on this paper
Click your name to claim this paper and add it to your profile.

Reviews

Primary Rating

4.6
Not enough ratings

Secondary Ratings

Novelty
-
Significance
-
Scientific rigor
-
Rate this paper

Recommended

No Data Available
No Data Available